The doctor show has been a staple of television since virtually the first Indian head signoff signal hit the airwaves 60-odd years ago. There have been shows which focused on one or two doctors and other more ensemble oriented pieces which have caught the public's fancy through the years. In the ensemble category, Grey's Anatomy seems to have overtaken longtime stalwart ER as the disease (actually diseases usually) of the week favorite of viewing audiences. In a recent real life survey, Seattle came in at the head of American cities in terms of treating cardiac arrest patients, but I had to wonder repeatedly while watching Grey's Anatomy how those patients might have fared had they been admitted to Grey's Seattle Grace Hospital, where the doctors seem too busy being romantically involved with and spurned by each other to ever do much with actual sick and/or injured people in need.
That of course is a bit of an exaggeration, but not by much. As Grey's Anatomy wound down its third season, virtually all of the major characters were in relationship disarray, with marriages in tatters, marriages that never quite happened, new affairs and old affairs and everything in between. It seemed to relegate the actual medical setting of the series to the background, something that may be intentional, but which seems odd in the long run. Unfortunately Grey continues that trend well into this fourth season; so much time is needed tying up loose ends and getting various characters' interrelationships worked out that any given medical crisis gets a few intermittent minutes of screen time per episode, usually as a sort of counterpoint to the main character dramas unfolding. Perhaps not so strangely, it's when the character and medical elements intertwine that the series is at its emotional peak, as in an episode where Chief Surgeon Webber's niece, a cancer victim at the tender age of 14, is admitted for another round of treatment and Webber must decide whether to support her wish to just die peacefully. And in a continuing arc for this season, the show admirably mines the twisted relationship between half-sisters Meredith and Lexie Grey, thrust together as Lexie, a new intern at Grace, is paired, like it or not, with Meredith, a resident, despite the fact that Lexie personifies Meredith's abandonment issues, not exactly a great foundation for sibling love and affection.
Add into this mix your usual, if fleetingly handled, standard and exotic medical crises, pretty much de rigeur for this and every other medical show, and you get a sort of manic soap opera, albeit one mixed with occasional blood and guts and those fifty dollar words that only doctors can pronounce. What sets Grey's Anatomy apart, and is ultimately its redemptive quality, is its sort of peculiar, yet amiable, high wire act which tonally shifts between lightheartedness and gravitationally intense drama. Any given episode can lurch from a moment of extreme sadness to sudden hilarity, and it's not as disconcerting as it may sound. It's also to Grey's credit that the characters are shown progressing--the five major players still on the series (Kate Walsh has left for the spinoff Private Practice and Isaiah Washington has left, after several homophobic statements, to watch his career spin off down the drain) have weathered various personal and professional crises and, as the fourth season opens, are all picking up various pieces.
Four of the five have at least progressed to resident status, after starting the show as interns. The fifth, George (T.R. Knight), has to repeat his interning after having failed to achieve residency by a single point. These five, Ellen Pompeo as Meredith Grey, Sandra Oh as Christina, Justin Chambers as Alex, Katherine Heigl as Izzie, and Knight as George, form the core around which the show revolves. There are also the two "hunks" of the show, focus of a lot of the first three seasons' buzz, Patrick Dempsey as Dr. Derek Shepherd, involved with Grey, and Eric Dane as Dr. Mark Sloane, involved with pretty much every other female in the series. All of the performers get their chance to shine in various episodes (despite Heigl's rather bizarre claim come Emmy time that the writers hadn't given her "nominee-worthy" writing). Oh's Christina is especially wonderful this season as she ping-pongs between tamped down rage and despair over her failed marriage plans. If Pompeo seems at times to be phoning it in during this fourth season, at least her subplot with Lexie (a charming Chyler Leigh) gives her a chance to show some chops, which she does in a very appealing, understated way. The supporting cast, notably Sara Ramirez as Callie, George's jilted wife, and Chandra Wilson as underling Miranda Bailey, do exceptional work in little moments throughout the season.
If the show is cloying and too cute for its own good at times, at least as the season progresses the writers seem to realize they can't have every character in the minefield of a major crisis and still be devoting time to the various medical predicaments that should at least be the foundation, if not the ultimate focus, of the show. As the season progresses toward its conclusion, various situations are finally resolved and the show at least fitfully returns to dealing with the doctors and their patients. If it leaves this fourth season seeming uneven and emotionally exhausting, it at least sets the show up for a more enjoyable fifth season, where perhaps the seemingly unending character dramas can be pushed to the background and the show can deal more with the interrelationships between the healers and their charges.