From the writers of Grey's Anatomy:
But first things first. Entirely too much happened in this episode. TOO MUCH. Owen went all PTSD and choked Cristina in his sleep then she forgave him and they had ridiculously beautiful sex until she realized she had to dump him after all.
Yup. Too much happened in this episode. I’m overwhelmed. I don’t know what to talk about first.
Let’s start with the unpleasant part. Owen. And the choking. This was a tricky one. Let’s be clear. This is not a guy attacking a woman because he’s a guy who attacks women. We did not set out to tell a story about domestic abuse. This is a story about PTSD.
Owen is completely asleep when he attacks Cristina. Asleep, having a nightmare. Remember the story we did earlier this season about the guy with night terrors? Same thing. Did you see how dead Owen’s eyes look? He has no awareness of what’s happening. And the moment he wakes up, when Callie calls his name and he snaps out of the nightmare – Owen is more discombobulated and confused than anyone else. That’s why Cristina’s line is so important, when she asks Meredith if it would be any more appropriate to abandon Owen right now than it would be to abandon someone who had suffered a stroke or a heart attack. Owen is wounded. He does have war wounds. Which, as a doctor, Cristina recognizes. And she’s not going to let that intimidate her. She knows wounds can be healed.
The point isn’t the choking, it’s where Owen goes from here... The story we’ve always wanted to tell is one of healing and awareness and treatment for PTSD. That’s part of what you’ll see Owen struggling with in episodes to come. But before we can get there, before Owen can be truly willing to seek out help – we needed to see him hit rock bottom. We needed him to realize that his symptoms aren’t necessarily within his own control. We needed him to choke Cristina.
And if you felt a little worried when Cristina and Owen started to kiss, if you felt a little twinge of heartbreak for the two of them as they finally, beautifully consummated their relationship… that’s what you were supposed to feel. It’s exactly what we see creeping into Cristina’s face, after the sex, when she can’t fall asleep. She’s having a very quiet, but very real panic attack right there in Owen’s arms. I feel like there’s a part of Owen and Cristina that knew – even as they were finally having sex after all this time – that this was actually a goodbye.
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