Grey-Sloan Memorial Hospital was turned on it’s head when an outsider was called in to reevaluate staffing decisions in Season 13, episode 7 of “Grey’s Anatomy.” While many were reluctant to accept Dr. Minnick’s call to take a teaching approach to every surgery, that outlook appears to have changed in episode 8 of the ABC drama.

Richard (James Pickens Jr.), Owen (Kevin McKidd), Stephanie (Jerrika Hinton) and Meredith (Ellen Pompeo) are assigned a difficult patient. When Season 13, episode 8 — titled “The Room Where It Happens”) kicks off, they are working tirelessly to save an anonymous man who they believe was hit by a car. Power struggles ensue, until Richard proposes they take a new approach — he orders them all to see their John Doe as a human, creating backstory details and more.

Stephanie chooses to see him as the IT guy she parks next to every morning before later changing her mind. Richard sees him as his mother, who learned in her 40s that she had pancreatic cancer. Owen sees the patient as his sister, whom he was unable to save. He is plagued by flashbacks to his military days and is coached through the procedure by her ghost. Meredith struggles to imagine the patient as anything other than the anonymous man he is until details roll in providing clues about his real identity.

While she argues with Owen and Richard about whether they’re making the right calls, a nurse enters the operating room to alert them to the fact that a woman has just come in looking for her missing husband. She wants to take a photo of the man to show her. The nurse reveals to Meredith and the team that the woman has two young children with her, which helps Meredith to picture the patient as her husband Derek Shepherd, who was killed in a car accident in Season 12. She has flashbacks to telling her two children about his death, which pushes her to work harder to save his life. Meanwhile Stephanie is visited by her childhood self, who urges her to find her voice.

She is repeatedly reminded that she knows more than she gives herself credit for, and is finally able to get Meredith, Richard and Owen to listen to her. Stephanie tells them that the patient has an autoimmune disease, which is the reason he won’t stop bleeding. His body is attacking itself from the inside out, meaning they have to change their approach. They do and they are ultimately able to get him into stable condition.

While scrubbing out after the procedure, Meredith confronts Richard once more. She thanks him for opening her eyes and apologizes for not being receptive to it. He explains that he has been using this technique for years, ever since he operated on a woman who had the same fatal cancer diagnosis as his mother and could not be saved. He tells her that he was “numb” while telling the family that she died in the operating room and vowed, from that moment on, to work harder to save patients. He leaves and Meredith takes a moment to soak in his words. During that time she’s visited by her dead husband in a flashback to one of their early meetings.

“Grey’s Anatomy” airs Thursdays at 8 p.m. EST on ABC.

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