Adam Taylor/ABC
Samantha Highfill
November 14, 2014 AT 03:37 AM EST

Here’s the thing about McDreamy: Much like the name implies, most of his original appeal came from the fact that he’s more or less the dream guy. He’s smart. He saves lives. His hair is the definition of perfection, and he loves deeply. Sure, he’s had his flaws over the seasons. There was the whole he’s-actually-married thing, and let’s not forget the engagement ring that he hit with a bat, but they’ve all been things that we as viewers have been able to explain away. “Yes, he’s still married, but somehow, he’s the victim because Addison was the one who did the cheating. It’s not his fault that he loves Meredith. Also, he did the commendable thing when he tried to save his marriage.”

As for the engagement ring? Well, “he was lost because of a patient that meant a lot to him, which points to the fact that he’s a good doctor with a big heart.” But what do we do with an imperfect McDreamy? There are moments in this hour in which I find myself disliking him, and it’s so strange because I can’t think of a time when I was against Derek on this show. I wasn’t happy with him when he took over for Richard as chief, but Richard did need to get help. I literally don’t know how to watch this show if I’m not rooting for Derek in some way.

Then again, by the end of this hour, I found myself loving the idea that our oh-so-perfect McDreamy had hit rock bottom. I think it’s a great story to tell and one that I’m very interested in… if only everyone around him would stop screaming so much and let him fess up to his issues.

Getting into the episode, we pick up with footage from Derek’s father’s murder intercut with a voice-over about second chances. Life gives them and so does surgery. Surgeons, however, don’t tend to get them. With that, we start things off in the ER, where nobody seems to be sleeping. Arizona can’t sleep for thinking about the Dr. Herman situation; Callie can’t sleep for Sofia asking questions about the divorce; and Meredith can’t sleep for all the sex she’s having with Derek. (One of these things is not like the other.)

Enter patient number one … and two. Out of the ambulance comes a man who refuses to stop holding on to his dead wife. After a fir started at their home, he grabbed his wife, jumped out a window, and then used his body to break her fall. The heartbreaking hero’s name? Norris, and his wife is Haddie. By the time Meredith convinces Norris to let his wife go, they find out that she’s actually still alive! The bad news is that they have a really awful daughter who shows up to the hospital only to realize that Amelia, whom she knows from Narcotics Anonymous, is her parent’s doctor. And not only does Ms. Sarah want a new doctor, but she decides to start screaming at Amelia and out her entire life story, a.k.a. all the stuff about how Amelia’s fiance overdosed and whatnot. Honestly, it was bad enough to let people know she’s an addict, but you did not have to go into such picturesque detail. Also, I wonder if Sarah can recite every group members’ life story or if she has some strange obsession with Amelia, because that was super detailed, right?

And the real kicker is the way that Derek walks right by his sister and takes her patient instead of hugging her. Yep, in this moment, McDreamy is an asshole. Meredith confronts him pretty much immediately, but he assures her that he’s going to talk to Owen about it later.

Elsewhere, Jo—now known as Dr. Badass—is preparing for her first ever solo surgery with “Little Bitty” Dr. Bailey looking on. After a good vomit, Jo completes a successful hernia surgery only to run to Edwards afterward and panic when she can’t remember if she skipped a step or not. When Jo goes to Bailey, the ol’ Nazi lets her stew for a bit before telling Jo that she knew all along that Jo had completed all the steps. The lesson: Jo can’t second-guess herself. And yes, Bailey’s mean. Get used to it.

Also in a panic, Amelia heads straight to Richard to find out what she should do next. But he assures her that she’s done nothing wrong. She’s sober, so if she can do her job well, then that’s all that matters. She can’t get away from her past, but that doesn’t mean she has to apologize for it. And that’s why when Hunt approaches Amelia later, she invokes her right not to discuss anything with him.

So when Hunt then goes to Derek, it’s time for the other shoe to drop, as Mer puts it. See, things have been good with Meredith and Derek and all their “time-out-ing,” but she’s just waiting for the other shoe to drop, which of course it does when she finds out that Derek only makes things worse with Hunt. Basically, after Derek helps save the secret-spillers mother, Sarah apologizes for outing Amelia before Hunt asks Derek if he thinks Amelia should be the face of their neuro unit. And when Derek doesn’t say anything, well, he says everything.

Also, just a sidenote for Hunt: Amelia didn’t kill her boyfriend. He overdosed. She’s a drug addict, not a murderer. Derek could’ve at least said that much.

NEXT: McDreamy, are you okay?

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