As usual, the patient of the week drew out personal parallels for many of our surgeons as they worked their professional magic to save their young patient. April, naturally enough, enlisted Jackson's help for an involved surgery to save Kamal's hands, because who better to save a patient close to your heart than your maybe soon to be ex-husband? When her patient arrived at the hospital we learned his illness was more severe than April originally let on and also that Nathan, Kamal's doctor / travel chaperone, seemed to strike a negative cord with Owen.
The initial interaction between the two men was unexpectedly terse as they exchanged harsh words. Just seeing Nathan put Owen on edge and his demeanor instantly grew hostile. Owen quickly impressed upon Nathan that he was not welcome in Seattle and should leave town as soon as possible. While we'd heard that someone with ties to Owen's past would show up during November sweeps, it now seemed likely we had met that person as Nathan responded by blithely saying, 'nice catching up' as Owen stalked quickly away.
The lion's share of the episode centered on Meredith's struggle to work with Penny, one of the surgeons who mistreated Derek the night he died, and secondarily on the growing rift between April and Jackson, so we learned precious little in this episode about Owen's new storyline. It remains unclear if we'll be learning about Owen's military past with the introduction of Nathan's character, or whether we might see a bit more about what happened in that year-long time jump last season in which Owen was absent from the story due to spending that time working as a trauma surgeon overseas.
Elsewhere in the hospital: Richard tried diligently to expand his relationship with his daughter Maggie while also mentoring Meredith; Penny experienced hellish hazing while stepping into her new role as a resident at Grey Sloan Memorial; April and Jackson's marriage continued to unwind as they treated a child April met as a surgeon overseas; Callie reached out to Penny while also supporting Meredith; Arizona tried to give her advice to April; Jackson gave Ben an important surgical responsibility and asked Callie for her assistance; Amelia and Meredith continued to be at odds; and Alex showed his supportive side to his friend Meredith.