E: This is the kind of episode title that has me freaking the heck out.

This week’s episode was about families, about children, and about the decision we make regarding them,  and how those choices echo down the generations.  It’s about Alex’s past as surrogate father to his younger brother, after the catastrophic failure of their own parents; Meredith, Cristina, Teddy, Mark and Callie all wondering whether they want kids, and how; a daring police officer whose husband wants her to stop getting shot at so they can have babies; Teddy and Owen, in combat flashes; a tender, dreadful storyline of the childless couple in agony.  It’s a good one.  It’s thinky, and a bit anvilicious, but it’s a good one.

The episode begins with Derek gazing soulfully (how else) into his wife’s eyes, rhapsodizing about how beautiful their children will be.  Meredith rears back.  Oh, now come on.  When you made that house for him out of luminaries, you made rooms for your kids.  You did that. You knew where this was going.  I suppose that’s always easier when its hypothetical, though.  She freaks out and complains to Alex (while he’s in the shower – he needs to pretend he’s a girl, she says) and later to Cristina.  Cristina is puzzled by Owen, who isn’t sleeping and won’t go back to his therapist (“men are stupid!”, she growls).  Callie is dumbfounded by Arizona, or rather by the insoluable problem they’re not talking about; Callie wants kids and Arizona doesn’t.  Teddy, on the other hand, is basking in the glow of Mark’s bedroom prowess: “he has skills I didn’t even know existed!”

And because getting divorce papers in the mail wasn’t enough, Alex’s little brother Aaron shows up with a herniated umbilicus.  This is pretty common in babies, especially premature baby boys, and since I had one of those, I’ve seen it before – but those tend to resolve themselves.  When the intestines start poking out of a grown up’s belly button, well, you need surgery.  Alex talks Bailey into doing the surgery pro-bono (since his brother, who works for a moving company, has no insurance) and soon Aaron’s been admitted and is blabbing to his brother’s shocked colleagues about how they have a teenage sister, Amber (all As – it’s a good thing his parents didn’t have any further to drop in my estimation) who is smart like Alex, how Alex practically raised him when they weren’t in foster care, how their mother’s a mentally ill junky and how their father beat them all up until Alex was big enough to stop him.  Even though we the audience knew most of that, it’s fascinating to see how stunned his friends are.  Aaron gets a shock or two of his own when he finds out Alex had an impromptu wedding to a cancer-ridden woman whom he’s now divorcing – all major life events which Alex never saw fit to confide with his blood relatives.  Words are said.  Accusations are thrown, and then punches.  Maybe you’re like Dad after all, Aaron gasps. After the surgery Meredith puts in a few good words for her friend, but Aaron still ends up back on the road too quickly.  Alex sends money, but that’s a lot easier for him that being around his family.

Lexie and April are helping Richard with the case of the childless couple, the Clarks.  The wife has beaten cancer, but now it’s back – which she found out after swooning amidst the frozen food in the grocery store.  “I’ve never fainted before.  I’ve never even seen anyone faint. I don’t even believe in fainting!” The husband is played by Michael O’Neill, who was the head of the Secret Service on The West Wing and also has played law enforcement types on Fringe, The Mentalist, The Unit, FlashForward and Criminal Minds to name a few.  Which is to say, you totally know him, though not necessarily like this; he’s the emotional one, he says, and he’s having trouble coping with the fact that his wife’s cancer has returned. I’m cautiously optimistic that I can remove all or most of it, Richard tells him – and he does.  But while Lexie is giving Mr. Clark the good news down in the lobby, April is watching his wife have a massive stroke.  By the time he’s arrived upstairs, she’s on a ventilator, and Richard and co are deeply afraid she’s brain dead.  Derek callously confirms this to April in their scan reading room, and asks Meredith to lunch in the same breath.   Richard tells Mr. Clark his wife is brain dead, and has a dnr order, which means they need to unplug her.  This does not go over well.

This storyline is very affecting; I doubt I was alone in crying over it.  Sometimes, though, the show touches on a subject I know a little about, and I can’t help watching it and thinking, I buy it,  but I don’t think it’s real.  A few weeks ago our uncle was put on a ventilator after a cardiac arrhythmia.  The hospital took several days before doing the testing to confirm brain death, because traumatic swelling can, as I understand it, disguise function.  I can understand why for dramatic purposes they didn’t wait, but as I watched the familiar heart ache, and the poor husband struggling to come to terms with his new reality, I wonder if in real life, having those three days would have made it any easier.  (Or if you can just get clearer pictures right away with a stroke? That I don’t know.) Also, the ventilator moves your entire body. Mrs. Clark lay still and silent.  My uncle shook and shuddered like a puppet, in some ways a mockery of his robust living self.  It’s easier to understand someone not wanting artificial assistance when you see what  it really is.

That’s enough of that.  Owen, Teddy, Callie, Cristina, Avery and a passel of other people are working on the final patient of the night, a cop who stormed into a crime without back up.  Unidentified doctors are taking on the three criminals she shot.  She’s now under review and might not get her job back, which would suit her husband just fine, because he wants to have kids – of course – and won’t while his wife daily balances her life on such a fine edge.   They rush her into surgery to fish three bullets out of her and repair her insides.

During surgery, no one can stop talking about the dilemma.  I can understand that, says Teddy.  Life’s different when you’re under fire.  You can’t imagine going there, Owen concurs.  You have to put the desire aside.  What, you want kids, Cristina wonders of Teddy (but not Owen?). You don’t, puzzles Teddy.  Have you met me, snarks Cristina.  To her it doesn’t even merit the question.  Teddy sneaks a glance at Owen, who’s a little stunned.   And then the successful operation goes quickly south when Cristina glances against a bullet which Teddy and Owen know explodes on contact; explode it does, right into the woman’s heart.  Teddy and Owen are pissed, and Owen is a little rough about it, but Callie stands up for her.  How would a civilian know what kind of ammo they were dealing with?  They’re able to repair the heart, but then the uterine artery starts spurting and they’re forced (surprise) to perform a hysterectomy.  Guess that puts paid to the baby idea.

When’s the best time to have kids, Callie asks Bailey in the staff room.  It’s kind of a weird question, I think.  What she means is, is this issue worth ending a great relationship for right now – or at least, that’s the way in which this is relevant to her life – but it seems like a spot for some clever monologuing and or a good place for a writer to rant.  And we all know Bailey is the mouthpiece of choice for ranting.  Bailey says never, launches into a tirade about how much work they are, and then relates a cute story about how Lil’ Tuck has just mastered the K sound, and unreasonably, she found that achievement as satisfying as performing a whipple.  Her point?  That there’s no easy time and kids a huge commitment and turn your life upside down and also kind of wreck it, but are worth it.  Fair assessment, I suppose. There are clearly times that are better for having kids than others, but the relevant bit of information is that you can’t wait for things to be perfect if you really want kids, because they almost never are.

M.r Clark insists on going to the Chief about his wife, and Derek tells him coldly that their ethics board has reviewed the case, but there’s no way around his wife’s order. It’s murder, says Mr. Clark.  Sorry, says Derek unconvincingly, but it’s time to call your family and anyone who would want to say goodbye. Is he detaching like this on purpose?  What happened to his vaunted bedside manner?  This was infuriating.  There is no one, Mr. Clark says.  We never had kids.  There is no one else.  For the first time, Derek actually makes eye contact, and turns his complete empathy on.  April gets caught in the blast, and sucks him her breath.  Lexie chases her down in the hallway, and reads a deeply embarrassed April the riot act for falling in love with her brother-in-law.  Later, lucky Lexie gets to pull the plug, and have a terrifically sad conversation with the husband about it, and it’s much less ugly than it could have been.

Adrenaline-junkie police officer Gina is devastated to find out that she can’t have kids. (And it wrecked Callie to tell her about it.)  Soon, however, she and her husband have decided to adopt a Jolie-Pitt sized family of Haitian orphans now that she’s off the force.  She loves her job, but it’s just a job.  Or it is until her captain and colleagues rush in to tell her the review board cleared her and she’s got her job back.  The husband gets shoved aside, and the joy on her face (and the frustration and anger in his) tell us everything.

Because it’s killing her to see him suffer, know how to help and not be able to, Teddy explains to Cristina how to get Owen to go back to his therapist.  Of course, Owen is wound so tightly that he ends up scaring Cristina with his inappropriate level of rage over some burnt sausages, and when he sees that, he decides on his own (which was essentially Teddy’s point) that he has to go back.  He had attempted to bring up the kid issue, but it all got lost in the tussle for the frying pan.

Callie forces Arizona to talk about the kid issue.  Poor Arizona has really been trying to pretend that the sword is not, in fact, hanging over her head.  We don’t see the result of the conversation, only the start.  Will they be broken up by the next episode?  Will Arizona agree to think about it, even though she feels strongly that the accompanying worry would be too emotionally draining?

You’re not your father, Meredith tells Alex, once he and brother have made up and the Aaron’s hit the road again.  You’re not your mother, he shoots back. You’re good.  You’d be a good mother.  And you know, I think she’s come far enough that she would, if that’s what she actually wants.  And I’d like to think that even her darkest days, her suffering made her too empathetic to be the same sort of bad mother Ellis was; she just wasn’t making healthy or consistent choices.  And was drinking too much.  So was she just complaining, or does she really think that she’d be a bad mother?

As they end the day in bed together, Derek tells Meredith that he just doesn’t want her to be alone if something were to happen to him.  This is practical as well as caring; we know that Meredith’s tendency to depression can go deep enough to threaten her life.  She says she’s open to thinking about it.  They start kissing.  Just thinking about it, she reminds him.

As a mother, I can tell you something important, and it has nothing to do with my kids learning to pronounce things correctly.  (Actually, that always makes me a little sad, because the mispronunciations are so particular and so damned endearing.)  I’m not going to say that everyone ought to be a parent, but Sheppard is right.  I am more whole because there are pieces of my heart walking around outside of me.  I am not alone.  Children can break your heart, it’s true, and you can hurt despite your best efforts.  I have more to lose, but I am rooted and surrounded in love.

Mark is licking chocolate off Teddy’s back.  She tries to tell him that she’s in love with someone else, much as she’d rather be open to being in love with him, but he won’t hear it.  I was convinced the person knocking insistently on Sloan’s door (breaking up an immanent chocolate bellybutton fest – which, I hope these are skills she knew existed) was going to be a distraught Callie, but no, it was little Sloan.  In labor.  Huh.

All in all, I enjoyed this episode.  The euphemism of the week may not have been rip-snortingly funny, but maybe “pounding each other’s cake” will take off.  I’ve rarely like Derek less. I have a feeling we haven’t heard the last of April’s crush.  And I fear for Callie and Arizona.  But I am feeling very secure about Teddy and Owen.  That is going to happen. They belong together.  They just do.

*Hey.  I’m back to add that you absolutely have to read the writer’s blog, Grey Matter, to find out that when they wrote this incredibly baby heavy episode, they didn’t actually mean it to be about babies.  Hee.   Also, Mark is in love with someone.  And he was supposed to admit that to Teddy.  I’m glad they took that out, because I really want him to get with Callie, and that’s definitely not something he could have confessed to in this episode.  Grumble grumble…