Grey’s Anatomy’s milestone 200th episode (Season 10, Episode 4: “Puttin’ on the Ritz”) is all about a fundraising gala and celebrating, but inside at least one patient’s room, things are far from happy.

As seen in the promo, Richard is still bedridden and not doing well, but he’s not accepting Bailey’s help. In a new sneak peek, we see the severity of the situation, including lots of screaming — and even violence!

“Let go!” Richard screams at a nurse, and Bailey quickly comes to intervene. “I don’t want this,” he says with a cough when she comes to his side, but she’s not going easy on him.

“There’s a man down the hall. He is ornery, he’s a jackass, he is dying, and he won’t stop fighting even though there isn’t anything I can do for him,” she says sternly. “And then I’ve got you. You’ve got a million options and you refuse to try.”

After explaining his severe condition and how he’s in danger of pneumonia or something worse, she holds up something to help him breathe and says, “Meredith Grey is ready to let you slip into a coma, but I am not. You breathe in through this, your lungs get stronger, you get better. It’s damn simple math. What do you want to do?”

There is a brief moment of hope when it looks like he’s going to take her advice… but then he throws it across the room. From there, the ultimate struggle begins. Bailey tries to put a mask over his face, but he dismisses that too, pushing her so hard away from him that she falls over roughly as he screams, “Get the hell out!”

It looks like it’s going to be a rough road ahead. Are you shocked that Richard isn’t trying and getting violent with one of his closest friends and mentees? Check out the full clip below, then sound off in the comments.

Grey’s Anatomy’s 200th episode airs tonight, Thursday, October 10, at 9 p.m. ET on ABC.


Alyse Whitney is Assistant Editor at Wetpaint Entertainment. Follow her on Twitter and Google+.