What if? It’s a question many of us ponder throughout our lives, wondering how things could have changed had just one part of our lives been different. Grey’s Anatomy tackled the idea of “what if?” with a formula-bending alternate universe episode which presented a very honest look at what would have happened had Ellis Grey never had Alzheimer’s.

Honestly, an alternate universe episode is something I had never even considered when it came to Grey’s Anatomy. There are many other formula-bending episodes I’ve wanted in the past that have actually come to fruition, such as the “shooter in the hospital” scenario and the musical episode, but I never once thought of the idea of an alternate universe episode. So when it became public knowledge that Grey’s Anatomy would be entering into this foray come February sweeps, I was both intrigued and excited to see what would come of it and, more importantly, how it would be done.

More specifically, I was interested in seeing what the launching pad would be for entering the alternate universe. The idea of “what if?” is too generally broad to base an episode around, so I was pleased to find that the episode centers around the idea that Meredith’s mother, Ellis Grey, never came down with Alzheimer’s, which leads to a string of many other changes within the lives of those at Seattle Grace Hospital.

What I came to find with “If/Then” was a shockingly honest look at what would have happened in lieu of Ellis’s sickness and death. Though I have always been excited about seeing the episode, I couldn’t help but worry that many of the stories would seem contrived, especially given that many of the core characters from the earlier seasons, such as Izzie, George, and Burke, would not be back for the hour. But I was thrilled to see that every explanation for every event or missing character in “If/Then” not only made perfect sense, but was honest to the story that has been told for the past eight years.

Though of course it was a shame that Izzie was missing from this new universe, I was able to accept with no hesitation the idea that she ended up getting fired after falling in love with a patient (Denny). Not only that, but I was even able to accept the fact that Meredith turned her in and the others supported her in that decision. It made sense, for the group of interns would have never formed a close-knit friendship and defended and protected Izzie when everything went down.

It was also deeply saddening to find that George was missing, because I’m sure I’m not the only one that felt like this would have been the perfect opportunity to see one of the show’s most-beloved characters one last time. However, it made sense that he still would have failed his medical boards, but without the support of the other interns, and without the support of even “Mandy,” George would have never been convinced to repeat his intern year. I like to believe that in this universe, somewhere out there, George is alive and thriving, though given the message of the hour (that whatever is meant to happen is meant to happen), I’m willing to bet he still jumped under a bus to save a girl, but the doctors of Seattle Grace never knew about it.

But there was so much more to the hour than the absences of Izzie and George. There was also a seemingly nice and reformed Alex, who Meredith seems to believe she has tamed and fixed into a suitable man that is now Chief Resident at the hospital. However, unbeknownst to her, Alex is sleeping with Meredith’s “person,” the “virgin” April, something that loner Cristina discovers by opening the door to an infamous on-call room.

It was certainly interesting to see what Cristina’s fate would have been without Meredith by her side. Turns out her relationship with Burke still happened, but something unexplained occurred between the two that had Burke fleeing the hospital – and the state. Cristina is referred to several times throughout the hour as “crazy,” “creepy,” and “scary,” and what was so funny about this was that I felt like Cristina was still Cristina, but without somebody by her side, nobody knew how to take her, and that scared everyone.

But in Burke’s absence comes Callie, taking over the role of Cardio God for the hospital, which is explained as being a result of Ellis suggesting it. I’ve seen a lot of people talking about how they can’t buy Callie as Cardio God. I can buy it, and I can totally see it too. My only gripe with Callie’s storyline was how it also intermingled with Owen’s. It was never really clear to me how those two ended up together – and with three kids to boot – and Teddy had suddenly became a man. It was the only thing that I felt like didn’t really match the timeline of the rest of the series, but I was able to overlook it because, well, this universe isn’t real. And not only that, but it was very clear that Callie was feeling some serious sparks with the mysterious Peds surgeon…

Seeing Lexie be admitted to the hospital as a crackhead was a lot of fun. It was great to see Chyler Leigh so different and pull it off so effortlessly. Having suffered the loss of her mother to the same condition that claimed her in this universe and her father to suicide following that, Lexie’s resorted to drugs, tattoos, and piercings to feel something (or, perhaps, to not feel anything at all), and it winds her up in the hospital under the false moniker “Lucille Ball,” which led to some of the best banter between her and Jackson (who did a creepishly fantastic impression of Desi Arnaz, if I do say so myself). I also found it quite interesting that the thing Cristina and Meredith ultimately ended up bonding over was saving Lexie.

Unfortunately, it seems that The Shepherds weren’t long for either universe, as Dr. “McDreary” and his wife end up still suffering the same fate by the end of the hour, which I can’t say I am too bent up about. While I would gladly die any day to have Kate Walsh back on Grey’s Anatomy (no offense to Private Practice, I love you!), her relationship with Derek ended up just never feeling right, and it seems that that is a fact that stays true in all universes. So The Shepherds remain in a loveless marriage, except this time, there’s a baby on the way too! And boy, how great was it to see Addison finally pregnant, even if it wasn’t in the real universe?

There were plenty of other goodies from “If/Then” as well, so let’s take a look…

• Hearing Charles Percy’s line “Just shoot me now” may have been the best line of the entire episode.
• It was enjoyable to see “Mandy” once more, though it was painful to watch what she was going through, and I’m glad that The Nazi started to come out more by the end of the episode.
• One of the best parts of the episode was being able to actually see Ellis and Richard together and happy. Considering how much we’ve heard about their past and their relationship, we’ve never really seen them together, so this was able to paint a much clearer picture and it was a thrill.
• It was also a thrill to see Kate Burton grace the screen once again, as having Meredith’s mother around is always juicy. I was pleased to find that Ellis seemed to stay true to the spirit of who the character is, but because she is happy with Richard, she is also a bit less edgy.
• It was highly unsettling to find that Meredith’s last name was “Webber.” I mean, I suppose it does make sense, but “Meredith Webber” and Webber’s Anatomy so do not have a good ring to it.
• Can’t lie, as adorable as Meredith and Alex were as a couple, I was also secretly thrilled to get a glimpse of Alex and April together as well, even if the revelation literally made me gasp aloud.
• The other revelation that made me gasp? Finding out that not only was Addison’s baby not Derek’s, but that it was Mark’s, and the final scene from “I Am a Tree” reenacted. I feel dumb for being surprised (because, HELLO! This has happened already!), but it still caught me off-guard and had me smirking in delight, especially when Eric Dane once again uttered that fantastic line: “Well this is awkward.”
• I had actually completely forgotten about Mark up until he showed up on the screen at the end of the episode, and his appearance had me smiling in delight.
• This episode is a perfect companion to the very first episode of the series, “A Hard Day’s Night.” The references back to the episode were probably too numerous to list, but for us die-hard fans of the series, we caught them all and made watching the episode that much more enjoyable. The re-use of the music from that episode was also a really unexpected and pleasant surprise, and the moment I heard “Portions for Foxes” playing in the background, I knew that we were in for a real treat.

I never really expected “If/Then” to let me down, but it far exceeded my expectations. It was a great thrill ride and visit back to the past. This episode, probably more than ever, is a true “love letter for the fans,” and I certainly couldn’t have loved it anymore.

Still, while watching the episode, I found myself finding that as much as I was enjoying this alternate look at the way things could have been, I was so glad that this wasn’t how they had been. (Granted, had this universe been the actual show, Ghost Denny would have probably never happened.) It really made me appreciate the show that much more and the stories that were told and the way they were told. Because as great as this episode was, it would not have been nearly as enjoyable to watch. It made me glad that things happened the way they happened and really opened my eyes to that.

Plus, it would have ended up being the same show anyways, starting with a girl in a bar meeting a boy in a bar…

Rating:

813 If/Then, Featured