Ariana Bacle
March 13, 2015 AT 04:52 PM EDT

Remember that Post-It, the one that united Meredith and Derek together forever? The one they—and we—thought was a binding contract between the two? Well, Meredith throws all that away in the beginning of this episode when she trashes the framed Post-It after Derek leaves for D.C. And this is how Grey’s makes its return after two months away.

Meredith’s bitterness toward Derek is expected, sure—he did decide to leave Seattle in the last episode we saw, after all—but it’s also heart-shattering. The two have had their ups and downs throughout the show, but they’ve always seemed like the couple that was going to work. But right now? They are definitely not working.

Because Derek’s gone, Meredith has to find a nanny to care for their kids while she’s at work. She gets derailed by work though when Owen announces today’s big assignment: A woman drove herself—and her two kids—off a bridge, resulting in a multi-car accident. “Maybe she needed a nanny,” Meredith quips. What she really needed was surgery, but we’ll get to that later.

Speaking of kids, April found out hers might have osteogenesis imperfecta. In non-doctor speak: her unborn child could have bones so fragile that they often break without reason—and could live only a few days outside of the womb, if that. This news is awful, obviously, and Jackson thinks April should spend some time outside of work to deal with it—but April wants to work, so she does. And honestly, being distracted by saving someone’s life in an OR sounds a lot better than wallowing at home and Googling osteogenesis imperfecta.

Jackson, being the worried husband that he is, gets involved and asks Owen to get her out of the OR. Owen tries to, but April fights him. Her reaction seems justifiable at first, but then she starts maniacally cackling and it gets weird real fast. Eventually, Owen orders her to drop her tools and she steps out only to confront Jackson. This episode is extremely feminist, and April scolding Jackson is one example of that: She’s pissed that he and Owen are treating her like “a little lady” in trouble, which they totally are—but also, she is in trouble and it seems like they are more worried about her well-being as a human than asserting their dominance over her. But April’s going through some shit, so this is probably not the time to question her logic.

While Meredith and April are dealing with their personal struggles, Arizona is trying to help Herman get rid of her brain tumor. At first, Herman’s pissed because Arizona broke her trust, but eventually she realizes getting her life saved doesn’t seem like the worst option and goes to Amelia for her medical opinion. “The tumor is smart, it’s brilliant,” Amelia tells her. “But so am I.” This is one of many times the tumor is personified in the episode, which makes me kind of want to give it a name. But I’ll leave that for Herman to do.

After some characteristically stubborn pushback from Herman, Amelia tries to convince her they need to operate, like, yesterday. Herman continues to be stubborn and says, very calmly, that she wants to wait until the last moment possible to operate. She might be a pain in the butt, but she also has some solid reasoning: The longer they wait, the more time she has to impart her knowledge on Arizona, and the longer she has her life. If they operate now, there’s a very good chance she could die on the table. So there’s that. As the show has taught us again and again, tumors are the worst.

NEXT: Meredith’s day doesn’t seem quite so bad now…

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