“How much pressure a human being can withstand?” Meredith Grey (Ellen Pompeo) begins this episode before she recites Murphy’s Law, saying that all it means is that “anything that can go wrong will." It’s a negative, ominous start for an episode with a just as ominous title: “It Only Gets Much Worse,” is a story about conflicts: conflicts between husband and wife, between bosses and inferiors, and between -- of course -- warring sides. The largest conflict of season 13 centers on doctors picking sides against other doctors, families splitting down the middle, and operating rooms wielded like machine guns. The sides are thus: Dr Bailey (Chandra Wilson) , chief of staff, versus Dr. Webber (James Pickens Jr.), the man who trained her. Bailey’s side is weak in manpower. Besides her and brand new protege April Kepner (Sarah Drew), the only other people on Dr. Bailey’s team are the residents, who are lowest on the totem pole, and their teaching doctor, Eliza Minnick (Marika Dominczyk). On Dr. Webber’s team is almost the entirety of the attending staff, plus the now exiled Dr. Grey. What Dr. Bailey has going for her is sway. Because she’s the big boss, what she says goes. This episode, Dr. Minnick institutes “Phase Two” of her teaching plan. Minnick is already disliked by almost everyone on staff for co-opting OR rooms. But mostly she’s disliked because Dr. Bailey hired her to take the place of Dr. Webber teaching the residents. This drama has been dragging on for almost five episodes, and as a central drama, it is incredibly boring. Office politics, no matter how important, are never really that interesting. But this episode is really a turning point for not only the show, but for that plot line because there are actual emotional stakes that really work. In “Phase Two” of Minnick's plan, two residents per week get to lead a surgery from start to finish. The attending, who is more qualified, and possessive of her OR, can only assist the resident performing the surgery. This is contentious at best. First up? Dr. Ben Warren (Jason George) and Dr. Stephanie Edwards (Jerrika Hinton). Ben Warren, husband of Dr. Miranda Bailey, is immediately cajoled for his early pick. More than anyone else, he’s in the absolute center of this war evolving in the hospital but until right now I had totally forgotten about him. Married to Bailey, but a resident by status, Warren is in a position where he can’t do anything but bow his head and do his job. Bailey, though, doesn’t realize how central her husband is in this war, and ignores him. When Warren begins his Phase 2 surgery, it’s in the most compromising position: working with Dr. Webber. Bailey inserts herself into the OR and ruins his experience by creating a fight. This ruins Warren’s experience and leaves him at the end of the episode saying that, “this was my first; I’m never gonna get another one.” By the end of the episode, Warren and Bailey are fighting in their home, and he still can’t tell her which side he feels like he belongs on. The real drama of the episode though, starts and finishes with Dr. Edwards’ surgery. After her first surgery falls through because the patient died, Edwards and Minnick go “trolling” down to the Emergency Room to find her a patient to do her surgery on and they come back with a 9-year-old boy with gallstones who is devastated to be missing the launch of his cruise. Their glory doesn’t last long, though. Once Dr. Arizona Robbins (Jessica Capshaw) finds out, she joins the operation to supervise, promising to keep to herself. But, as the title and intro warned us, things get worse. After Edwards begins the surgery, something goes wrong, suddenly there is a lot of blood and the kid is crashing. The scene calls back to early great Grey’s Anatomy episodes by tuning down the conversation and medical jargon during the crash and overlaying it with music so that the only thing you can feel in the episode is panic. When the doctors emerge from the OR they are all in a state of shock. The kid has flatlined. “What did I do?” Edwards asks. “Did I kill that boy?” She did. But instead of comforting her, Minnick flees the scene. Edwards eventually has to seek refuge in the arms of Dr. Webber who tells her that it, “might be your worst, but it won’t be your last.” The drama isn’t over, though. Robbins, who already has sexual chemistry with Minnick, confronts her in the lounge. The job, she says is to, “teach them how to live through this. You are the attending. This is your loss. You take the hit.” But Minnick has never had a kid die on her table, and so Robbins ends up being the adult, the teacher, stepping in to comfort her even though she’s obviously furious with her for failing her student. Just as they prepare to head to tell the parents about their son, they find Webber already in there with Edwards telling them. Whether this event will draw the two sides closer together or pull them apart further is yet to be seen. The third plot line of the episode is the most tangential and the most unaffecting. Compared to the marital drama of Warren and the devastating loss of Edward’s patient, the petty drama revolving around April Kepner is child’s play. No matter how much the show tries to convince us the April Kepner is a good person who loves her family and is a very good surgeon, she is still incredibly annoying. There’s something about her earnestness that never really plays well in a crowd and certainly doesn’t give her the illusion of authority. April, taking over for Dr. Grey, has also received all of her patients. One of them is a woman with esophageal cancer who doesn’t want Kepner to do her surgery any more than the other attendings want her there. The patient isn’t easy, but Kepner makes it harder. There is a heart attack, and Kepner messes up the staples and they have to do the whole thing over. In the process Kepner kicks pierce out of her OR and by acting so impulsively and angrily, proves that she isn’t ready for that kind of leadership. The episode flies by. Grey’s Anatomy is at its best when every commercial break feels like a painful separation from the story, and every single one does in this episode. It’s an episode with a lot of emotional weight. There aren’t any surprises, but every bad thing carries weight. “Once things start going wrong; it’s hard to break the cycle,” the Meredith voiceover says. And for most of this season, Grey’s has struggled to keep attention and emotion at its forefront. But here, tonight, they broke the cycle.