A quick review of tonight's "Breaking Bad" coming up just as soon as I sell that hideous crying clown...

"Mama." -Holly

Funny story, folks. Late last night, I found myself in my local emergency room, dealing with a lot of stomach pen pain that was revealed to be a bad case of appendicitis. I'm okay, and am even lucky enough to be in a hospital that has AMC in high-def (what are the odds?), but I'm writing this review while both high on painkillers and feeling, even after the surgery, incredibly sick to my stomach.

I am, in other words, in the perfect physical condition to have just watched "Ozymandias."

I didn't imagine "Breaking Bad" could top the final sequence of last week's episode for tension and power and ability to induce a state of complete, nauseous panic. I was wrong. "Ozymandias" is one of the very best episodes of this great, cruel show, but also one of the most sickening.

After the teaser flashes back to the first time Walt and Jesse came to this curse spot in the desert — back when Walt could still imagine the drug business being easy, harmless money, and when he could focus more on Skyler's proposed name for their incoming baby girl — we pick up in the same spot (with the RV fading out and then Jack and Hank's cars fading in) with the shootout between Hank, Gomez and the Nazis all done, in the only way it could be. Steve is dead. Hank is badly wounded and still hopelessly outgunned, and Jack has long since decided to kill him. We see that Walt still has some level of humanity, and love of family, left in him, as he sacrifices his buried treasure in a futile attempt to save Hank's life, but Hank knows what's what and takes a bullet to the head...

... which finally sends Walt over a cliff, as he spends most of the rest of the episode lashing out at the people who have been dumb enough to care about him. He gives up Jesse's location to the Nazis, blaming him for his role in Hank's murder (because he has no ability to hurt Uncle Jack), and decides that this is the perfect moment to tell Jesse about how Jane died. In all the years since season 2, as I've turned over and over in my head the idea of how and when Jesse might find out about this — coming closest in season 3's "Fly," also directed, like this episode, by the amazing Rian Johnson — I never imagined that Walt might be the one to come right out and tell Jesse, and to do it out of nothing but pure spite.

And yet as terrible as the desert aftermath was, with the Nazis getting their hands on both Walt's cash (most of it, anyway, as Uncle Jack leaves Walt with one barrel — one barrel and $11 million as payoff for all of Heisenberg's awful crimes — as a sop to Walt-admiring Todd), it was nothing compared to the later scene at the White residence, with Skyler demanding, D'Angelo Barksdale-style, to know where Hank is, then trying to protect her son with a carving knife from the evil, evil man she married. I thought that Skyler and Marie fighting over the disposition of Holly a few weeks ago was as emotionally low as this show could go, but then we had Walt and Skyler brawling on the living room floor while Holly screamed and Flynn jumped in to save his mom, driving Walt away from his family forever, and briefly trying to take Holly with him.(*)

(*) Because of tonight's circumstances, my wife was in the hospital room with me as I watched the episode — her first "Breaking Bad" ever. Unsurprisingly, she did not respond well to the Holly abduction scene, and to the absolute despair of Anna Gunn's performance. Threw her into the deepest end of the pool possible.

Walt has always justified his meth cooking as something he was doing for his family, but as his wife and son stare at him like he is history's greatest monster, and as he steals his baby daughter from her terrified mother, his actions are exposed for what they've always been: indefensible.

Though even now, Walt isn't all gone. Holding Holly in the bathroom, and hearing her ask for her mother, at least breaks the spell long enough for him to realize that he can't take her, and that he has to do everything he can to protect Skyler from the consequences of his actions. His call to the house is, on the surface, yet another disgusting expression of Walter White's pride, but it's really just another performance by master thespian Heisenberg: doing everything he can to make sure the cops think all fault belongs to him, and that Skyler (who, I think, realizes what he's doing as the invective gets angrier and angrier) is simply his blameless victim. It's the only decent thing he has left to do before he hops into the minivan of Saul's guy and prepares for his new life in New Hampshire as Mr. Lambert.

The only downside to watching this episode while impaired is that I can't do full justice to its genius in this review. I'm too punchy right now, and should probably just be laying down. Maybe later this week, I'll revisit it with a longer, more coherent look. Because this was incredible, and horrible. Hank and Gomez are dead. The Nazis have Walt's fortune, and have a brutalized Jesse as their prisoner to help Todd cook meth. Marie is a widow. Flynn has had his entire worldview shattered. Nearly everything bad that could happen to these people has happened. And we still have two hours, a machine gun and a ricin capsule to get through.

Oh. My. God.

What did everybody else think?

Alan Sepinwall may be reached at sepinwall@hitfix.com