Grey's Anatomy: Examining the Patient

Grey's Anatomy originally followed Desperate Housewives on Sunday nights, and is experiencing a similar life cycle. Both shows were popular and critical hits out of the box (though critics have always been a little more divided on Grey's). But even as the ratings for Desperate Housewives remained solid, the kudos for the show waned dramatically in its second season, as complaints mounted about superfluous new characters and ridiculous behavior from the old ones.

Grey's Anatomy began to experience this backlash last season. The show survived its move to Thursdays; even with the weaker lead-in of Ugly Betty and the tougher competition from CSI, ratings remained as good as ever. But many of its most ardent fans spent the season in a state of panic over what they were seeing on the screen. The show's namesake character Meredith Grey pushed every last nerve with her interminable off-again on-again romance with Derek Shepherd aka McDreamy, to the point where many were hoping the episode where she hovered between life and death would end with the latter winning out.

The decision to pair off George and Izzie was greeted with general disbelief, partially due to the sense that Grey's was overdosing on workplace hookups, and partially due to their manifest lack of any chemistry. The show was never a big one to showcase the everyday working lives of doctors, and became less so as it began to rely on late-period ER stunts like the big ferry accident. And Grey's, like Desperate Housewives before it, started to show up in entertainment press controversies, the biggest one involving the fight between Isaiah Washington and Patrick Dempsey.

So as Grey's airs its final new episode of the season, we can judge whether or not it has made any sort of creative comeback in its fourth season. The evidence is incomplete. Some of the less successful elements of Season Three have been pared back; while they're going about ending it very slowly, they seem to have decided to stop torturing us, and Katherine Heigl and T. R. Knight, with the George and Izzie business. At least one of the new characters--there's always at least one new character on Grey's--looks to be a strong addition. But it does seem as if the show still loses sight of its core relationships on occasion, at the expense of moving the doctors into new pairings like a game of medical musical chairs.

Last season ended with Washington's Preston Burke character leaving Cristina at the altar on their wedding day, a prelude to Washington departing the show entirely (he was last seen going down with the Bionic Woman ship). Washington probably couldn't have stayed after the controversy over his fight and homophobic remarks directed at Knight, but he was a weighty presence on an often frothy show, and losing an original character was a blow. The departure of Burke has given Cristina less to do this year, a problem since Sandra Oh is one of the better actors in the cast.

Grey's also lost Kate Walsh after last season when she moved on to Private Practice, which draws decent ratings but has yet to impress anyone as something other than the junior varsity Grey's. Replacing Walsh, less in position at the hospital than in the role of "authoritative-appearing 40-ish woman," was Brooke Smith as cardiothoracic surgeon Erica Hahn. Smith has rare talent for network television and unprecedented talent for this show, so landing her as a regular was a coup. The key now will be to keep her acting like a serious doctor and not as someone using the hospital as a dating service, which is always a struggle on Grey's. Hahn is the sort of type A personality who tends to get far in that field in real life, and so far she has been an interesting contrast with the others.

The other new regular this season, Meredith's half-sister Lexie (Chyler Leigh), hasn't been as terrible as feared (what people were fearing was another Meredith). But Grey's is about where ER was at during its first years of development, where original cast members were beginning to get restless and new people were shuffled in and out without any attempt to stop and think how to use them. The latest example is Rose (Lauren Stamile), the new love interest for McDreamy. The character seems to be here because Grey's doesn't want to pair up Meredith and Derek for good--no more tension, no show, or so the theory goes. But the new characters are stepping on the toes of older characters people have invested in.

More of a focus on the actual work of doctors is always a good thing on Grey's--the two-parter that represented the two most recent episodes was a good example. The next move, once people are writing for the show again, will be to flesh out some of the thinner new characters (if they stick around), and give some of the older ones like Cristina something to do. And if Katherine Heigl takes off for a movie career as now seems increasingly likely, don't panic. Trust me, she and Izzie are expendable.