Grey’s Anatomy Recap: Derek Reaches the End of His Rope – And Who Gets Devastating News?

Hope was a major theme on tonight's midseason finale of Grey's Anatomy, for better or for worse. Meredith (Ellen Pompeo) and Derek (Patrick Dempsey) may have given up completely on trying to repair their marriage, and Stephanie (Jerrika Hinton) and Arizona (Jessica Capshaw) found out some devastating news about Jackson (Jesse Williams) and April's (Sarah Drew) baby. On the other end of the spectrum, Dr. Herman (Geena Davis) might have more of a chance at survival than she originally thought, and Callie (Sara Ramirez) and Arizona are making progress towards a reconciliation — though not necessarily a romantic one.

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Let's recap:

At the start of the episode, Meredith's caught in the middle of an argument between Derek and Maggie (Kelly McCreary) over which one of them should operate on a patient first. Maggie thinks she should, Derek thinks he should, and Meredith takes her sister's side. The awkward argument that ensues between Derek and Maggie in front of the patient and her mother — and Derek's subsequent Blue Steel glare directed at Maggie — is a far cry from the welcoming hug Derek gave his new half-sister-in-law a few weeks ago. Sheesh.

While giving April an ultrasound, Stephanie (who has rebounded remarkably well, I might add, from Jackson dumping her for April) accidentally lets it slip that the newlyweds are having a boy, and also notices something strange on the monitor. Uh oh.

Callie and Owen (Kevin McKidd) are continuing their veterans project with a cool virtual reality simulator game — and less-cool traditional physical therapy, which results in a patient falling and cracking his head open. Turns out walking with an avatar is easier than walking with an actual prosthetic.

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Dr. Herman, meanwhile, is eating ice cream for breakfast because she's dying, dammit. We learn that she is divorced, has no kids, and counts Graham (Nicholas D'Agosto), Arizona, and her job as her family. (Sad.) Arizona, who's really uncomfortable with Herman's flippant attitude towards her own mortality, keeps pestering her for more info about her condition. After Herman becomes annoyed to the point where she kicks Arizona off of a surgery, Arizona takes matters into her own hands by requesting that Dr. Herman's entire medical records get sent to Amelia (Caterina Scorsone), in her name.

This definitely unethical, possibly illegal plan unsurprisingly backfires when Amelia notices Arizona picking the folder up and wants in on that action. Amelia, devoted surgeon that she is, practically salivates while looking at Herman's brain X-rays with the same longing gaze that I'd bestow upon a dessert buffet.

After last week's fracas, Amelia (who's preparing to operate on the newly-injured veteran) tells Owen the truth about her pill-popping past and thanks him for keeping her employed even though it's a risk. Am I the only person rooting against an Ow-melia romance? It's a sweet moment, but I'm just not sure about these two.

Well, here's a surprise — Arizona walks in on Dr. Herman and Graham in flagrante delicto behind a closed door. What was that Amelia was saying about inappropriate sexual behavior being a symptom ... ? But, when Arizona confronts her, Herman says the sex is not a symptom of her tumor, but a side effect of dying early. Like with the ice cream, Dr. H is trying to cram in as many flavors of orgasms as she can before she dies (or something like that), so she's livid that Arizona yelled at Graham about it. He's a tool, but good in the sack allegedly, and so Dr. Herman says that she's "going to screw as many Grahams as I can." Well, alright then.

President Obama, refusing to take no for an answer from Derek, has sent a muscle-woman to the hospital with the instructions to change his mind. (Off-topic, but how cool would it be if President Obama actually guest-starred on Grey's? If anyone could convince him, Shonda Rhimes could.) But Derek's more focused on his and Maggie's ongoing pissing contest, with Meredith getting annoyed that Derek enlists Richard (James Pickens Jr.) to give a second opinion (over hers), and continuing to take Maggie's side over her husband's.

Stephanie asks Arizona to look at April's ultrasound, and whatever's (potentially) wrong with Jackson and April's baby sounds bad.

With the veteran in surgery and Owen angry with her, Callie is feeling like everything's her fault. Arizona notices, and tiptoes over to offer her a bit of comfort (and complain that everything's going badly for her, too). Arizona asks Callie if she misses her, and Callie responds, "Of course." Is that a flicker of hope?! No. "But not enough," Arizona notes sadly, and then walks away. I'm on the fence about whether this budding friendship(?) between them is lovely or devastating.

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Speaking of finding comfort, Owen checks in with Amelia to make sure she's getting the support she needs for her addiction. In return, she asks Owen if he has anybody to talk to and says that she's there for him (literally just across MerDer's yard) if he needs someone to lean on. Okay ... maybe I'm starting to come around to this pair.

When Arizona and Stephanie ask Dr. Herman to take a gander at April's ultrasound, she confirms their worst suspicions — that the fetus has a congenital defect that causes very fragile bones, and it probably won't live more than a few days or weeks, if it even survives birth. Making matters worse, April excitedly tells Stephanie minutes later that she can't keep a secret from Jackson and is going to tell him that night that they're having a boy. You know who is good at keeping secrets? Stephanie, who grits her teeth and hugs April without sharing her newfound knowledge.

At the end of the episode, Maggie, who's been avoiding Richard since the dinner party, finally confronts him for siding with Derek in their surgery argument, and they agree to meet for coffee. Baby steps!

So, here are the big cliff-hangers we're left with until the show returns in January:

Jackson overhears Stephanie re-confirming with Dr. Herman that the baby is doomed. Completely heartbreaking that he knows they're talking about April's ultrasound because of the reference to their "Buddha baby." How will he react to the news?

Amelia, to Arizona's horror, has wallpapered a seldom-used room in the hospital with scans of Dr. Herman's brain. (Why do I feel like, for her, this is akin to a teenage girl plastering her bedroom with posters of One Direction?) Anyway, when Arizona flips out, Amelia says she thinks she can remove the tumor and save Dr. Herman's life.

And the big one:

Meredith and Derek have it out again, and they're both clearly sick of fighting. Meredith tells him to take the job, and he calls her bluff — calling Obama's muscle-woman and accepting the position right then and there. Meredith immediately flashes back to Cristina (Sandra Oh) telling her that she, not Derek, needs to be her own No. 1.

What did you think of the midseason finale? Will Derek really defect to D.C.? Are you rooting for an Amelia-Owen romance? And where will Jackson and April go from here? Sound off in the comments!

Grey's Anatomy returns January 29 on ABC.