How Insensitive/Grey Matter

Bill Harper on "How Insensitive"...

Original Airdate: 5-6-10

When Shonda told me, “I think we should have a 700-pound patient come to Seattle Grace,” the first thing I thought of was Patient Sensitivity.

We’d already discussed the idea of putting our doctors, infamous for their irreverence and dark humor, their ruthless and clever nicknaming of patients, into a lecture on Patient Sensitivity, and this seemed like the perfect patient to tie it to. Then, I started researching Bailey’s lecture, looking around for the kinds of things that hospitals actually recommend for doctors to do and say, and I found it really telling that almost every program I could find was aimed toward sensitivity to bariatric – obese -- patients. That’s partly because obesity is an epidemic in this country – more than one-third of Americans are considered clinically obese – and the medical community is racing to catch up. And also because, sadly, obesity is often called society’s last acceptable prejudice. So sensitivity to these patients apparently needs to be taught, stressed and re-stressed.

So we knew, with the arrival of this patient, we would explore patient sensitivity. And also see what sensitive areas these doctors could have exposed along the way.

In terms of insensitivity to patients, I think historically it’s been a dead heat between Alex and Cristina. So it was fun to realize that Alex, who might be the least sensitive person among them, could be the one who actually breaks through Bobby’s armor of jokes and the layers of despair that got him to this point, and helps him to see the good guy inside, the way his wife does. It’s the thing Alex has been learning about himself all season. And in turn, it helps Alex move forward, saying goodbye to Izzie for good. How big a step is he taking with Lexie, kissing her like that in front of the whole hospital, taking her hand? Not sure – but in Alex terms, it looks like a giant step to me.

And on the other hand...Derek. Arguably the hospital’s most sensitive doctor, Derek utters perhaps the least compassionate thing in the episode. It’s shocking, and instantly regrettable. Very Un-Dreamy. I’ll say I had a hard time with this coming out of his mouth, and I wrote it. But what Richard tells him is true, the job of Chief can eat away at you, transforming even the most caring surgeon into a callous bureaucrat. And Derek’s clearly having one of the worst days of his Chiefhood yet. That’s Derek’s continuing struggle, and when Mr. Clark comes back to sue him, Derek spends the whole episode wanting to do what he knows is right, to reach out to a broken man, to help, to heal, but he’s backed into a corner where his only job is to be factual, clinical and unemotional. Add to that the burden of all this sensitive information he has to control, and he and Meredith are in the same trouble they were in season one. Only now it’s worse -- their relationship doesn’t just affect their own jobs, it can potentially affect the whole hospital.

Then there’s Cristina. She has to be forcibly shoved into Patient Sensitivity, only to find this little girl who cracks her open and reveals her most vulnerable spot. Cristina’s forced to make the girl her patient, because she’s uniquely qualified to see Kelly through what was her most painful experience. I love the moment in the elevator, when she makes the choice without actually knowing why she’s making it – out of pure gut protective instinct. And, for my money, Cristina does the kindest, most compassionate thing she could do for a child– she lays it all out honestly and without sugar-coating it. It’s only when Jackson says it out loud to her, makes her acknowledge the truth, that Cristina’s own dam breaks and she has to let it out. Surprisingly, she chooses Owen over Meredith, to comfort her.

This was an interesting twist. I think it’s unusual for Meredith and Cristina to find solace in someone other than each other. But here, Cristina needs something from Owen that she has given to him – she’s seen him through his darkest hour, when his pain has come back to haunt him. He knows what this feels like, and knows what to do – how to just ride it out. And similarly with Meredith and Derek: He’s too fed up with parsing his words and being straight jacketed into a person he’s not, Meredith knows the only thing she can say is “I love you.”   She’s smart enough to know that sometimes a guy just needs to shut up. Or hit something. Like a few golf balls.

OK, now we have to talk about Callie and Arizona. They have become pretty much my favorite couple, the ones I could count on. I want them to stay together, but it’s unavoidable. Callie finds her own sensitive spot in this episode. She’s vulnerable -- not to the come-ons of an attractive patient -- but to the sense of possibility it represents to her. And that’s something she will never get from Arizona. Because Arizona simply does not want a kid. It is, as they say, a dealbreaker. As much as I hate this break up, I have to say I love this break-up, because it feels like something many of us have been through, when we realize that the one thing you’re not getting in a relationship is just important to you as the hundred things you are getting. I’m sorry it had to happen. And if you're as sorry as I am, I'll just say this...keep watching! Anything can happen -- and you might find yourself pleasantly surprised!

A couple of random notes on the process I found interesting along the way...

Jerry Kernion, the actor we were lucky enough to cast as Bobby, was an incredible trooper, withstanding up to four hours of getting into fifty pounds of latex each day to play the role, and then endured that blazing hot suit for hours on the set, smiling and joking the entire time. And all that latex didn’t hinder his incredibly charming and heartbreaking performance. Thanks again, Jerry.

Cristina and Kelly’s card game: We talked in the writer’s room about how it’s often easier for kids to take in big, important, monumental information when they’re not looking at you -- when they’re concentrating on something else. So I came up with the idea to have them play Slap Jack, which is a card game I play with my own kids. When I went online to make sure my family wasn’t playing by some insane rules we’d invented ourselves, I was surprised – and a little chilled -- to learn that there’s an alternate name for the game Slap Jack. It’s also called Heart Attack.

Kelly’s Mom: Was originally conceived as Kelly’s dad, suffering from a sudden heart attack. But Shonda thought it would be a good way to get out the information that heart attack symptoms in women present very differently than in men, and often aren’t recognized for what they are. Some women have been sent home from the ER with an antacid, when they were actually in cardiac arrest. I know we said it in the episode, but it bears repeating!

That’s it for me for this week, and for this season – but you’ve got two more incredible nights of Grey’s before we go... and trust me, you don’t want to miss them. If you’re a Demi Lovato fan, you’ll get a treat next week. And then the FINALE.... I know, we’ve all said it, but... holy crap, don’t miss the finale.

Thanks for watching!

Bill