Grey’s Anatomy Season 20, Episode 4 Recap: 8 Biggest Story Reveals

Warning! This article contains SPOILERS for Grey’s Anatomy season 20, episode 4.

Grey’s Anatomy season 20, episode 4 marked the return of Arizona Robbins for an important case, while the interns continued to work on their procedure logs in hopes of returning to the operating room. Jessica Capshaw exited Grey’s Anatomy in season 14 along with Sarah Drew (April Kepner), but while April has made multiple appearances since, season 20 was the first time Arizona returned to Grey Sloan Memorial Hospital. Upon leaving, Arizona moved to New York to be with her daughter, Sofia, but fortunately, a case required one of the world’s best fetal surgeons to come to Seattle.

The latest episode was the first to premiere since the news of the Grey’s Anatomy season 21 renewal. Having a character like Arizona, who first appeared in Grey’s Anatomy season 5, is a reminder of how much the series has changed and grown. Grey’s Anatomy season 20, episode 4 was also the first episode this season without Meredith, but Ellen Pompeo is set to return for at least one more episode. The blend of old and new guards is best shown through the interns, who are still paying for what happened in the Grey’s Anatomy season 19 finale.

8

Lucas Moved In With Amelia

Lucas wasn’t a good roommate

At the end of Grey’s Anatomy season 20, episode 3, Lucas surprisingly moved out of Meredith’s house, where he’d been living with Yasuda and Simone. He didn’t tell them he was leaving or where he was going, as he didn’t end things on good terms with either of his roommates. So while the move might have been surprising in the moment, it was also understandable. Luckily, he was able to stay with his aunt Amelia.

Grey’s Anatomy season 19 revealed that Lucas is the son of one of Derek and Amelia’s many sisters, though it’s unclear whether Nancy, Liz, or Kathleen is his mother. Amelia doesn’t have a good relationship with her sisters–none of them even bothered to attend her and Owen’s wedding–but she hasn’t let that affect her bond with her nephew. Despite being family, Amelia and Lucas haven’t shared many scenes in Grey’s Anatomy, and their new living arrangement provided an opportunity to explore their dynamic.

Unfortunately, Lucas doesn’t make for the best roommate. Amelia spent most of Grey’s Anatomy season 20, episode 4 frustrated with Lucas’ messiness and the fact that he took her car without permission. However, a conversation with Monica reminded Amelia that Lucas is just an intern, and she decided to cut him some slack, which led to a sweet scene between the aunt and nephew at the end of the episode.

7

The Interns Were Under Investigation

The interns were interviewed about what happened in the season 19 finale

While the interns were able to keep their jobs after the events of the Grey’s Anatomy season 19 finale, they are still dealing with the consequences of their actions. In Grey’s Anatomy season 20, episode 4, the interns were interviewed individually by a group of lawyers about their conduct with Sam, Maxine, and Teddy. The investigation’s results haven’t been revealed yet, but the fact that they’re being investigated in the first place suggests their troubles aren’t over.

Though Jules and Yasuda technically didn’t do anything wrong, they were lumped in with the rest of their intern class. Jules was removed as Maxine’s healthcare proxy at her son’s request, which upset her, while Yasuda just had to answer questions about Teddy. On the other hand, Simone told the lawyers she probably wouldn’t have operated on Sam if Lucas hadn’t been there, which could put the responsibility almost solely on him. With the new investigation, getting back into the OR could be the least of some of the interns’ worries.

6

Arizona Returned For A Groundbreaking Surgery

Arizona planned to operate on a fetus’ brain

After six seasons, Arizona finally returned to Grey Sloan Memorial Hospital to help Amelia, Jo, and Bailey with a pregnant patient named Vida. Though Arizona started Grey’s Anatomy as a pediatric surgeon, her fellowship with Dr. Herman in season 11 made her one of the world’s only fetal surgeons. Thus, it only made sense to call her when Vida’s fetus developed a rare blood disorder that affected the baby’s brain. The typical course of action in this case is to operate on the baby’s brain following birth, but Arizona hoped to be the first to perform the surgery in utero.

Jo and Amelia were immediately onboard, but Bailey had reservations, as did Vida. Since it wasn’t her role as a doctor to convince a patient to get surgery, Arizona prepared to leave before she was stopped by Vida’s husband, who convinced her to stay. To help reassure Vida, who has a history of vision loss, Arizona walked her through the procedure using 3D-printed phantom skulls, and she agreed to the operation in hopes it would save her baby after two heartbreaking miscarriages. Despite a complication during the surgery, Arizona, Jo, and Amelia were able to fix the fetus’ brain.

While many viewers expected Arizona’s Grey’s Anatomy return to address whether she and Callie got back together, she made no mention of her life in New York. Rather, her storyline was entirely centered around the groundbreaking surgery. Though this might be disappointing to some viewers, hopefully, this isn’t the last we’ve seen of Arizona.

5

Jules’ Brother Showed Up At The Hospital

Jules’ brother is a wellness influencer

In Grey’s Anatomy season 19, Jules revealed a bit about her family and how different they were from her. While Jules is determined and focused on becoming a doctor and making something of herself, she was raised by carefree parents who were more focused on doing drugs than raising their children. Grey’s Anatomy season 20, episode 4 introduced another Millin for the first time, Jules’ brother Doug, who also claimed to be a doctor.

However, Doug was a wellness influencer with no credentials or authority to practice medicine. Doug didn’t come to Seattle just to visit his sister, bringing one of the patients he’d been “treating” with him. Jules was tasked with draining a large lesion on the patient’s back, which she was able to do with the help of Yasuda and Owen.

When they completed the procedure, Doug fainted, clearly not used to seeing actual medical procedures. Upon waking up, Doug called Jules, interrupting her at an important moment. Fed up with always taking care of her brother, she called him out for being a fake doctor. Overhearing their conversation, Owen berated Doug for deceiving patients and potentially harming them under the guise of having a medical background. The stark contrast between Jules and Doug helps explain her no-nonsense personality and unwillingness to deal with other people’s problems.

4

Bailey Let The Interns Back In The OR

Arizona convinced Bailey to let them watch her surgery

Since Bailey was named residency director in Grey’s Anatomy season 20, she has been somewhat harsh on the interns, whom she doesn’t trust to be in the OR. Beyond making them follow her famous five rules, she gave them all procedure logs to complete before they’d be allowed to return to the OR. When Arizona learned of this, she argued with Bailey that magic could happen during her surgery, and without seeing it, they might not be motivated to get back into the OR.

Arizona was able to convince Bailey to let them stand in the room and watch from a distance, though they didn’t seem to appreciate the opportunity as they should have. Rather than take in the history-making moment, the interns let themselves get distracted, with half of them even leaving mid-surgery. Due to this, Bailey regretted even letting them in.

3

Richard Wasn’t Ready To Return To The OR

Teddy & Richard wanted to help each other

In Grey’s Anatomy season 20, episode 3, Teddy was finally released from the hospital after undergoing open-heart surgery, and in episode 4, she was able to return to work. However, Winston didn’t clear her to perform surgery, worried about her stamina. As the chief of surgery, Teddy was determined to do more than just desk work, and enlisted the help of Richard and Link.

Together, they performed procedures on dummies in the lab to try and convince Winston that she was ready to return to the operating room. Eventually, Winston agreed to let her perform a procedure, and Richard decided to assist. Yet, when it came time for the surgery, Richard left, not feeling ready to operate after nearly lapsing in his sobriety. Without Richard there, Teddy left as well, reassuring Richard that he was ready and that she’d be there for him.

2

Kwan Struggled With Performing A Procedure

Kwan was haunted by what happened with Maxine

In Grey’s Anatomy season 20, episode 2, a young John Doe, whom they later discovered was named Dorian, came into Grey Sloan Memorial Hospital with three gunshot wounds. Just when it seemed like he was gone, Kwan managed to save his life. After Yasuda spent Grey’s Anatomy season 20, episode 3 monitoring him, he developed abdominal compartment syndrome and had to undergo an exploratory laparotomy.

After all his complications, Dorian finally woke up in Grey’s Anatomy season 20, episode 4, but he still had a long way to go to being fully recovered. When things once again took a turn for the worse with Dorian, Schmitt had Kwan perform a central line on him, but he chickened out last second. Kwan then confessed to Schmitt that all he could see was Maxine. Schmitt told him that memorable patients will always follow you, but that it wasn’t necessarily a bad thing.

1

Bailey Changed The Rules For The Interns

Bailey is making the interns work together

At the end of Grey’s Anatomy season 20, episode 4, Yasuda became the first of the interns to complete her procedure log. This should have meant that she was cleared for the OR, but Bailey was still disappointed by the interns’ behavior during Arizona’s surgery. Due to this, she changed the rules for the interns regarding what they needed to do to get back into the OR. For the interns to earn their privileges back, all of them would have to complete their procedure logs. Until then, none of them were allowed in the OR.

To get this done, the interns would have to work together rather than fight for procedures like they’ve been doing since they were given the logs. Though this was potentially unfair to Yasuda, who didn’t do anything worthy of getting kicked out of the OR in the first place and even saved Teddy’s life, the interns need to stop seeing each other as competition. Hopefully, this will also lead to some of the interns repairing their broken relationships in Grey’s Anatomy season 20.

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