It's a miracle; after three seasons, a new calendar year is starting at Seattle Grace. But not a ton has changed for our fab five, at least not personally. And for poor George, they also haven't changed professionally. The other four are now residents and are also in charge of their own interns. Lexie Grey is on Cristina's team, and George is with Meredith. There's an awkward Meredith-Lexie meeting in the ambulance bay, but as they're escorting in multiple victims of a car crash, it's fairly brief (but annoying). Cristina gets a guy they think is dead until he takes a breath, and it turns out he's been internally decapitated. Alex gets the guy with a crushed knee who also turns out to have a psych disorder in which he eats everything around him, including scissors and spare change. Meredith gets the pregnant single mother whose arm is severed, and Izzie gets the deer that caused the accident. She also has a bunch of interns who think she's a lunatic, and while they're all awful themselves, she's not doing a lot to disprove this theory.
While they're all dealing with these various patients, there's naturally lots of behind-the-scenes drama. Derek tells Cristina that Burke has resigned from the hospital. Izzie bitches a lot about George ignoring her and eventually corners him to ask why he didn't say anything when she declared her love. Meredith is Meredith about having her estranged boyfriend and her sister who tried to pick him up in a bar working in the hospital at the same time. Alex wants an actual surgery (before he realizes that his patient has a taste for binder clips) and keeps trying to undermine Callie, who is struggling with a bunch of residents that don't listen to her. Bailey is mad about not being named Chief Resident herself, and George is struggling with his second first intern day. Ultimately, Lexie tells George to suck it up and they strike up the beginning of a friendship. Alex admits he misses Rebecca and Cristina admits she misses Burke in a rare but awesome moment between just the two of them. And George surprises Izzie by showing up at her front door and telling her he loves her too. I throw up a little. But the biggest news is that Derek and Meredith actually decide to officially break up…and then make it official with some break-up break-room sex.
Previously on Grey's Anatomy, pretty much all of Season 3.
The sun rises over Seattle and actually signifies something new -- a calendar year has now passed. Meredith's voice ushers us into this new phase: "In the practice of medicine, change is inevitable." The Chief puts his glasses on at his desk, clearly still Chief. "New surgical techniques are created, procedures are updated, levels of expertise increase." There's a whole mess of interns in the locker room; were there really this many when the fab five started out? "Innovation is everything. Nothing remains the same for long." That is, nothing except George starting over as an intern after failing his exam; he walks into the locker room with all the newbies. "We either adapt to change, or we get left behind." A group of four of the interns, including one Miss Lexie Grey, walk up to Cristina. She turns from her paperwork to look at them with disdain, and then announces, "I have five rules. Memorize them." I adore both the symmetry and the clear realization that Bailey was and is the most awesome resident ever as shown by the fact that she repeats the same rules they were given back when they were wee babies. I'm also kind of amazed that first-year residents get interns. I'm not familiar with the system so maybe this is normal, but it seems awfully soon to entrust the education of fresh faces to these four. It's never brought up as unusual, though, so on we go with their day.
Cristina naturally delivers rule one, to not bother sucking up as she hates them already. Cut to Izzie and rule two: answering all pages at a run. She then starts to walk, and her interns all hang back until she tells them glumly that they're supposed to follow her, and then they spring to action. Alex is walking his gang across the magical glass walkway and tells them their 36-hour shift starts now. He appears to have spent his time after the intern exam growing out his hair and cultivating a goatee. Meredith shows her gang (which includes George) the on-call room and tells them to get sleep when they can, adding that the sleep should not be with attendings. She's distracted herself, and George brings her back to the rules. Back to Cristina, Lexie asks about the fifth rule. Cristina menacingly tells them, "When I move, you move." It loses a bit of its punch, though, since her pager hasn't beeped and there's nothing to do. She finally just yells, "Go!" and they scatter.