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It's a lot of little things this week, with no major developments. McDreamy's sister pays an unexpected visit, temporarily leading Meredith to think Derek has another woman in his life. However, even after that mistake is cleared up, McSister's presence complicates things. It seems she loves McSteamy and Addison, and really dislikes Meredith. By the end of the episode, she helps McDreamy realize that he needs to take some time off from women, and he tells Meredith that he needs time and space to clear his head before they can get together.
It's Izzie's first day back at the hospital, and she's not allowed to do anything except follow Meredith around and observe. But she just can't keep from butting in when she realizes that a potential lawyer who burned her hand days before the bar exam actually burned herself on purpose to avoid the exam. It's Izzie's personal experience with failure that helps her convince the self-burner to let herself be admitted for psychiatric evaluation.
George is on the OB/GYN rotation and gets to help Addison take care of a pregnant woman who has two uteruses, each one of which contains a fetus. It turns out that the babies were conceived at different time by different men, leading to some consternation on the part of the mother's fiancé. Alex, who is now doing scutwork for McSteamy, becomes engrossed in the case and ends up stepping into the surgery in which Addison delivers one of the two babies (leaving the other in its uterus). McSteamy is an utter ass, and tells Alex to abandon any hopes of a career in plastic surgery. And the fiancé's willingness to commit to his babies and their mama convinces George that it's time to commit to Callie. Unfortunately, she's pretty sure she'd rather have George stop chasing her.
Finally, Cristina continues to cover for Burke, even scheduling him to perform an incredibly rare heart surgery, despite the fact that he's not really up for it. Bailey schedules herself to assist in the procedure, but Cristina is too worried that a resident would notice Burke's problem, so she erases Bailey's name from the board. Unfortunately, this just feeds Bailey's own fears that other doctors are doubting her competence after the Denny fiasco. This leads her to pay a little more attention to what's happening with the board, and she ends up realizing that something is going on with Cristina and Burke. Want more? The full recap starts right below!
Previously, on Grey's Anatomy, Callie broke up with George and his fun, fun video games, Meredith broke up with Finn and chose McDreamy, Bailey got raked over the coals at the M&M, and Cristina was secretly helping Burke cover up his shakes.
We open on disgusting surgery footage. Cristina is assisting Burke, and there's blood everywhere. Meredith's VO tells us that being a surgeon requires major commitment. Burke gets a hand cramp and Cristina dives right in, grabbing the small saw he was about to use to cut the patient up. Mere VO: "We have to be willing to pick up that scalpel and make a cut that may, or may not, do more damage than good. It's all about being committed. Because if we're not, we have no business picking up that scalpel in the first place."
The surgery is finished, and Cristina is overseeing a nurse who's filling in slots on the surgery board. Cristina has clearly taken complete control over Burke's surgical schedule, giving instructions on which O.R. he should be in, who should be on the scrub team, and what time he can operate. A resident walks up to her and hands her a latte. She takes it, but recognizes that it's a bribe and tells the guy he can't scrub in on Burke's surgery. She rebuffs another resident who makes the same request and tells them to shut up and go away. And then she goes back to nagging the nurse. We do learn that she wants Burke in an O.R. that doesn't have a gallery. The nurse makes a comment about how particular Burke has gotten since he returned to work, and Cristina threatens to rat the nurse out. So the theme of this episode is clearly people not noticing the enormous problem that's staring them right in the face, because there's no way anyone would think Cristina's behavior was remotely normal.
To prove my point, we see that Alex, Mere, and George are spying on Cristina. George and Alex are clearly unhappy that Cristina is running Burke's board, but Meredith thinks that she's just helping him out. Alex thinks that Cristina is taking advantage of the situation, since she's been able to get out of rounds and has scrubbed in on every procedure Burke performs. Meredith continues to defend Cristina until everyone sees Cristina snatch the marker away from the nurse and start writing on the board herself. George: "She's writing on the O.R. board!" Alex: "Maybe I should sleep with Burke." Get in line, buddy.
In the locker room, Meredith, Alex, and George sit (or stand) at one end of a bench while Cristina sits at the other. Meredith notes that Cristina's been busy and then complains that even though it's been a week since she told McDreamy she broke up with Finn, he still hasn't called her. Cristina doesn't really respond, and Meredith asks if she'd like to get a drink and catch up. Cristina blows her off, explaining that she has way too much studying to do to get ready for Burke's surgeries the day. And then she leaves, still dressed in her scrubs. George walks out, and Alex gives Meredith a look. But Meredith is still defending Cristina, telling Alex, "She's busy."
In a corridor, George chases after Callie and calls her name. She looks back, but doesn't stop and doesn't speak. He asks her several times to please talk to him. She just shouts his name once, and keeps on walking. George notes that he at least got her to say one word. If he gets her to say two more, I'm guessing they'll be "fuck you."
McDreamy's trailer. He walks out of his shower, towel in hand, and screams. There's a woman in his bedroom. She's got this skinny Ashley Judd thing going on, if Ashley went out and got herself a lipstick lesbian haircut that says "I may dress femme, but I'm still a butch in the sack." Ashley Dudd tells him, "Hey, stranger." He wraps the towel around his waist and complains that she didn't call before coming over. Also, her name is Nancy. And then Meredith knocks on the door and walks into the trailer. She starts to speak, but then sees a woman lounging on McDreamy's bed while McDreamy stands there mostly naked. She's stunned, and walks away. McDreamy chases after her trying to explain, but he decides not to run outside in his towel. Nancy seems thrilled to have gotten this reaction. Nancy: "I take it that was the slutty intern you cheated on Addison with?" McDreamy: "She's not slutty. What are you doing here?" Nancy tells him that she's there because he bailed out on Thanksgiving and Christmas and has been spending time with the slutty intern. By the way, they're just now reacting to the fact that he skipped Thanksgiving and Christmas? What month is it in this universe? I mean, we're 42 episodes into the one-year internship period -- are we ever going to get to a second Thanksgiving or Christmas? I feel like I'm recapping Lost. Or maybe Apartment 3-G. ("I see it's later that same afternoon.") (Although actually, truth to tell, I am loving Apartment 3-G and some of the other soap opera comic strips right now. I don't think there's anything on television that can compare to the saga of Aldo Kelrast and Mary Worth.) McDreamy: "I really don't like you." Nancy: "You love me."
The day, George, Meredith, and Izzie are in the elevator at the hospital. George and Mere both seem kind of sullen, while Izzie is nervous; it's her first day back. She's clearly looking for support from them, and they each are too withdrawn into their own funk to give it. But she's too nervous to really notice. She gets off before the two of them (as she has paperwork to fill out), leaving them alone on the elevator. George and Mere each look at the other (carefully not catching each other's eye), and then George says, "Okay, I'll be Cristina for you if you'll be Izzie for me." So George is going to make really rude comments and Meredith is going to kill a patient, cook mountains of food, and leave millions of dollars just lying around? Meredith says it's a deal, and George stops the elevator. Meredith goes first, telling George that McDreamy had a woman in his trailer. Mere: "She was ugly. Very ugly. Except she was tall and beautiful. And he was naked." George's eyes go wide at the last part, and then he remembers that he's supposed to be Cristina. He scowls and says, "McDreamy was doing the mcnasty with a mchottie? That mcbastard!" Okay, George just used up all 'mc' in the world. I'm calling a mcmoratorium, at least for this recap. (For those of you who don't actually watch the show, McDreamy's real name is Derek, and McSteamy's real name is Mark.) George asks Meredith how his Cristina impression was, and she tells him it was very good. Now it's George's turn. He tells Mere that Callie won't forgive him, won't talk to him, and dumped him. Meredith: "You deserve better. You do. You are George. Seriously. I mean, seriously. Seriously." She asks if she nailed the Izzie optimism, and he looks a little creeped out by it. They decide that they have both become pathetic, and then give themselves a pep talk about needing to focus on their careers. George suggests they take a pact not to date and to just focus on work. They decide that Derek and Callie are dead to them and then bump fists.
And we cut to two people shaking hands. It's Burke being greeted by the wife of a patient, Pruitt Byrd. Cristina gives the bullet on the patient, who has a tumor in his heart. Mrs. Byrd is clearly one of those patients (or patient spouses) who have become informed about their condition, and he tells Burke that they were told that Pruitt needed a "cardiac auto-transplantation." Cristina tells us that the real name for this is the "Humpty Dumpty" procedure -- they take out the patient's heart, remove the tumor from inside the heart, and then replace the heart in the patient. (In other words, transplanting his own heart back into his body.) Burke tries to explain to Mrs. Byrd that it's a very complicated surgery and it will take time to tell if Mr. Byrd is ready for it, but every time he tries to put up a roadblock, Cristina tears it right down. She's already done all the testing and she's decided Mr. Byrd is a perfect candidate. Which is why she's scheduled him for surgery that afternoon. Wow. That's kind of presumptuous.
In his office, the Chief tells Bailey that the legal department cleared Izzie to return to work. He wants Bailey to remind Izzie of the rules of her probation, and Bailey seems surprised that Izzie is being assigned to her. The Chief thinks it's only natural, since Izzie is Bailey's intern, but Bailey (with a touch of panic in her voice) suggests that it would be better for Izzie to start fresh with a different resident. The Chief asks if Bailey is saying that she doesn't want Izzie. Bailey: "I want her to succeed." The Chief takes off his glasses and tells Bailey that after everything that happened with Denny, there are doctors in the hospital who have concerns over Bailey's judgment. Bailey is thrown for a loop and asks if the Chief shares those concerns. He doesn't answer, instead asking her if she has those concerns. He tells her that the best way to put those concerns to rest is to climb back onto Izzie and ride. I mean, get back on the horse and ride. By which he means, demonstrating that she can take responsibility for Izzie and make her a good doctor.
At the ambulance bay, Addison walks out to an ambulance to greet a new patient. George gives her the bullet: the woman is pregnant with twins, one of which seems to be developing faster than the other. The patient is Noel, and her fiancé is Greg. He keeps reminding everyone that they are soon to be married, and she tells him that she really doesn't think people at the hospital are such prudes that they care that they are not yet hitched. That's certainly true at this hospital. As the gurney is wheeled into the hospital, Addison tells them that she doesn't quite see why Noel was transferred from Mercy Hospital to Seattle Grace, since there doesn't seem to be any kind of emergency. Noel tells them it has something to do with her "thing." Well, yes, the babies will come out of your thing, but I don't see why that's relevant. But then George, who has been reading the chart, shouts out, "Two uteruses?" George: "[Noel] was born with two uteruses. Uteri?" I would suggest uteria. But Addison tells him to go with "uteruses." George leans into Noel and tells her, "That's very rare."
Izzie nervously accosts Bailey and tells her that she's done with all the paperwork and really glad to be back. Bailey walks away, and Izzie follows. Bailey wants to be sure that Izzie understands the rules of her probation. Izzie claims that the lawyers went over all of that, but Bailey is talking about her own special rules. Namely, she's not allowed to speak to, touch, or be alone with any patients. Bailey continues: "You will perform no procedures. The O.R. is off limits. No pre-op. No post-op. No anything-having-to-do-with-an-op." I will laugh and laugh if her first patient is a pre-op transsexual. Bailey continues: "You have no authority. You have no opinions. And you have no choice in this matter." Izzie understands and asks if there's anything she can do, because she wants to be useful. Bailey: "Well, I can't use you." Izzie needs to earn back the trust of the other doctors. Until then, she'll be assigned to follow a single doctor each day and will do whatever that doctor asks of her. Bailey assumes the doctor will be an attending or a resident. But Bailey's decided that her doctor for the first day will be Meredith. Meredith has arrived, and Mere and Izzie are both surprised. But Izzie just grins and accepts the fact that Meredith is the boss of her. Non-credits.
Izzie and Meredith walk out onto the Bridge of Sighs and Whispers, and Meredith apologizes to Izzie. Izzie: "It's not your fault. Hey, you want me to fetch you some coffee? Rub your feet, maybe?" Izzie is walking backwards as she mocks Meredith, and she bumps into a man who is standing to Derek. Derek sees Meredith, and clearly wants to speak to her, but Izzie announces that she's not allowed to leave her boss's side. And then Nancy walks up, telling Derek that the trailer sucks but that the land it's on is pretty. Nancy: "Plus, you have your thing for ferries, so..." Derek and Meredith simultaneously correct her, pointing out that the term is "ferryboats." And then Derek introduces Meredith and Izzie to Nancy, who is (as you have no doubt figured out) his sister. Meredith is quite relieved and starts to laugh about it. Nancy tells her, "I knew you didn't think I was the wife, seeing as how you already ran her off." Oooh, she's a mean one. Derek tells them that Nancy is visiting from Connecticut and is heading back there immediately. Meredith, still giggly, tells her it was nice to meet her and walks away. As they leave, Izzie tells her, "McDreamy's sister is mcbitchy." Hey, what did I say? No more of that this week.
Burke and Cristina walk down a corridor. He's chastising her for scheduling the Humpty Dumpty, and she reminds him that he put her in charge of his schedule. But he did that so he wouldn't get a super-hard procedure like that one. She points out that only a few people do a Humpty, and he's the best one on the west coast. I assume that determination was made before he got the D.T.s. Burke thinks the patient could fly to Houston, but Cristina wonders exactly how he would explain to the Chief that he couldn't do the surgery. What Burke's most worried about is that Cristina told the patient he would do the surgery before telling Burke about it. She notes that she's been doing that all week, and that she's studied up on the surgery. Cristina: "We are a well-oiled machine." She walks away, and he bites his lower lip. And then Bailey walks up to him and tells him that she's heard some folks are concerned about her judgment. He tells her that everybody loves a scandal. She asks if he thinks it's just gossip and not actual concern. With an absent-minded air, he pats her on the shoulder, says "sure," and walks away. And that was pretty nice, because it's totally believable that his distraction would look to her like dismissiveness, undermining her self-confidence.
Meredith is treating a young woman with hideous looking burns on the palm of her right hand. She doesn't get a name for a very long time, so we'll call her Barbri. She asks Izzie to fetch some wound dressing and then sends her back when she brings the wrong one (it only being the wrong one because the protocol was just changed). Barbri is babbling on about how she's studying for the bar and was totally distracted when she started to make some tea, leading to a fire (or something, it's not quite clear) and the burns on her hand. This woman is way too cheerful for someone with the kind of burn that we were shown. Meredith asks her if she's going to be a lawyer. No, Mere, she's just taking the bar exam for the fun of it. Believe me, it's a real ball. Barbri says that she'll be a lawyer as soon as she passes the bar. She failed before, but she's ready now. Izzie tells her, "Good for you," and Meredith gives Izzie a look. A look that says, "Shut up and stop talking to patients."
Derek and Nancy pedeconference. He tells her that her ambush of Meredith was mean, and she tells him that another sister (Kathleen) called and asked her to find out why the slutty intern's panties were hanging on the hospital bulletin board. And just to be clear, the only way any of Derek's sisters would know about that is if Addison told one of them. Derek notes that he has four sisters and not one brother. God, no wonder he's got such great hair -- they must have been giving him hair care tips from the time he was an infant. Nancy would like him to stop expressing anger at his sisters and explain about the panties. Derek tells her that it's been great to see her, but that he really should get to work. She points out at that she had work to do as well. (She's an obstetrician and has at least one patient back in Connecticut who's close to giving birth). She maintains her relentless assault, noting, "Okay, we've covered the trailer, we still need to cover the slutty intern and the divorce." Derek looks at her with a sly look on his face and tells her, "You know what? You sound more and more like Mom every day." That is clearly the right button to push, because she follows him onto the elevator yelling at him to take it back.
George is strapping a fetal heartrate monitor onto Noel, telling her that having two uteruses is pretty cool. It's kind of like a super power. He also tells them that the two of them being engaged is cool. Noel tells George that Greg had to talk her into it. How romantic! Greg tells George, "From the first moment I saw Noel, I was ham." George politely nods at this, and then does a doubletake: "Did you just say 'ham'?" Greg explains his breakfast theory of love: "You're either ham or eggs. You've gotta ask yourself in every situation, are you the chicken, or are you the pig?" Because the chicken makes a contribution to a lovely breakfast of ham and eggs, but the pig makes the ultimate sacrifice to bring you that glorious meal. And then George gets it.
Mark (née McSteamy) calls out Alex's name and asks him if he's free. Mark has a cell phone pressed up against his ear. Alex, thinking he's about to get put on some interesting plastics case, tells Mark that he is free. So Mark hands him the phone, telling him that he's on hold with the DMV to deal with transferring his license to Washington, and asking him to deal with it. Alex: "Thanks for thinking of me, sir." And then Alex dials the phone before pressing it against his ear. Wasn't Mark on hold? Why did Alex dial the phone? George walks up, and Alex asks him how it feels to be doing the scutwork on the OB/GYN rotation. George: "Oh, I've got a patient who was born with and is pregnant in two uteruses. Two uteruses. Jealous?" Alex claims not to be, but he's clearly a big liar. George leaves, and Nancy walks up to Alex to ask if she really just heard that there's a patient with two uteruses. Alex has no idea who she is, but then Mark sees her and calls out, "Nancypants?" She calls him a loser and hugs him. She asks him if he's trying to torture Derek by moving to Seattle, and Mark tells her that he can't give up on his friendship with Derek, who is his family. He continues, "Plus, I needed a change of pace. Plus, I slept with my tennis partner's wife and he went out and bought a gun." I'm not an advocate of violence, but I think everyone's life would be greatly simplified if that tennis partner would take the gun and shoot off Mark's junk. And then Addison sees Nancy and excitedly runs over to give her a hug. Addison immediately realizes that Nancy's mother must have sent her out to check up on Derek. And then Derek, at the other end of the corridor, sees his three favorite people in the world talking to each other. Nancy calls him over, but he just walks away. She calls his name and runs after him. But not before telling Addison that she wants to see the two uteruses. After she leaves, Mark and Addison both sigh about how much they miss her.
In Noel's room, Greg is delivering sports commentary to Noel's belly. Alex watches from the door, and Noel tells him that Greg has decided that one of the babies is a sports fan. Greg tells Alex that the sports commentary calms the baby down when she kicks, and Alex notes that he's read a couple of articles on how a fetus can respond to voices. Addison enters the room and accuses Alex of secretly missing OB/GYN work. He denies it and pushes past George to leave the room. Addison tells Noel and Greg that they've got great news: according to their tests, the babies are perfectly healthy. However, they were conceived approximately six weeks apart, which is why one of them is so much bigger than the other. (The son is the older one.) This news is quite a surprise to Greg, who recalls that six weeks after Noel got pregnant the two of them were in the middle of a short separation, so there's no way she could have gotten pregnant again then. Unless, of course, she had sex with another man. Greg is angry, and Noel is muttering her apologies, claiming that it was a one-night thing while they were on a break. He walks away. George comes to the rescue of all the stupid people in the audience and points out that Greg is not the father of both babies. Commercials.
Addison walks up to Bailey and tells her, "I just accidentally broke the news of my patient's infidelity to her fiancé." Hmmm, it's kind of like that time you broke the news to Derek's girlfriend of his infidelity to his wife. Bailey notes that even though Addison just royally fucked up, nobody is doubting her competence. Addison agrees, and then does a doubletake and asks what Bailey is talking about. But the Chief interrupts any explanation, walking up to them and complaining about how he just lost a button on his last clean shirt. They look at him as if wondering what he expects them to do about it, and he explains that Adele always took care of his buttons. You know, Chief, they'll take care of that stuff for you at the dry cleaners for just a few bucks. It's just a thought. Addison asks if the Chief has called Adele, and he hasn't, because he wouldn't want to bother her with something "as trivial as a button." Maybe you could bother her with something less trivial, like the future of your marriage. And is it just me, or is "crappy excuses not to talk to your loved one about something important" the running theme of this season? The Chief looks hopefully at Addison and Bailey and wonders if either of them could maybe possibly sew on his button. Addison tells him that she has two uteruses to take care of, and Bailey tells him, "I have many skills. Surgical skills. Your button ruptures its esophagus, I'm your woman. Otherwise...." And with that she walks off. Aw, poor Chief -- it sucks when girls won't do your menial labor for you. The Chief pulls his lab coat closed over the gap in his shirt where the button would be.
Mark is examining Barbri's hand, and asks her if it's true that she burned her hand because she was studying. She tells him that while she's studying for the bar, she shouldn't be allowed to heat soup. Or tea, which was her last story. Izzie gives a look indicating that she may have noticed the discrepancy in Barbri's story. Mark gets Barbri to continue the story and she claims that she dropped the pot of soup because it was red hot. But when he points out that to get the kind of burns she has she must have held on to the hot pot for at least a little while, she changes her story and claims to have held onto the pot before she dropped it. Izzie is biting her tongue to keep from speaking. And here's the problem I have with this plotline -- if they want to give Izzie a triumph of perception on her first day back, that's fine with me. But it shouldn't come at the expense of making Meredith look like a moron. And if even Mark (whose head is normally shoved so far up his own ass, or the nearest vagina [metaphorically!] that he can't observe anything) notices something wrong with Barbri's story, there's absolutely no excuse for Meredith not to notice. Mark gives Meredith some treatment instructions for Barbri, who notes how sad it is that she won't be able to take the upcoming bar exam due to her injuries. But Mark reassures her that she'll be healed up enough to take the exam, and she gets a scared look in her eyes.
Cut to Izzie speaking privately to Meredith about Barbri's case. Izzie is convinced that she's lying and that something is off about her case. Meredith notes that Izzie is only supposed to be observing. Well, yes, Meredith -- that's why she's telling you about her suspicions away from the patient. Izzie notes that when she heard she could take the test, Barbri looked scared, not relieved. And not for nothing, Izzie, but this might have been the time to point out the lie about how she got burned. Meredith doesn't even listen to Izzie and accuses her of being nervous and bucking the rules of her probation. Izzie notes that she's just worried about their patient and tells Meredith, "Get off your high frickin' horse." Meredith points out that Barbri is her patient, not Izzie's. Izzie gives her best "grin and bear it" smile, and walks away with a dismissive "whatever."
At the nurse's station near the surgical board, Cristina looks at some kind of image of a beating heart on her laptop. Suddenly we hear Bailey's voice; she's noticed the Humpty Dumpty on the board, and very excitedly writes her name in as the resident on the case. Cristina looks utterly panicked.
George walks to Callie and tells her that he's aware that she's not talking to him but that he'd really like her to listen to him. She keeps walking away, so he grabs her elbow and pulls her back towards him. And then he tries to explain about the pig and the chicken, but he does it in that flustered little boy way he has, and he mostly ends up telling her that he knows that he was the chicken and she was the pig. Of course, her first reaction is, "Did you just call me a pig?" George: "It's a metaphor." Callie: "Calling me a pig?" (By the way, George -- if you call her a pig on the boards, I will ban you.) George boldly tries to continue his explanation, telling her, "What I'm trying to say is that I'm the pig. Now, I am the pig." Callie doesn't seem inclined to disagree with that statement, and she just walks away.
Izzie walks down a corridor carrying her tray of completely untouched cafeteria food. She stops and looks into a patient's room, where she finds all of the other interns sitting around and eating lunch. She explains that she's been waiting for them for half an hour in the cafeteria and asks when they started eating lunch in a patient's room. She just sat there, waiting? And didn't eat one bite of her apple or her sandwich? How emotionally needy are you when you can't even eat until your friends join you? George introduces Izzie to the patient in whose room they are eating: "Izzie, meet Really Old Guy." In fact, there's a really old guy sleeping in the bed while everyone around him eats or (in Cristina's case) studies for surgery. Since Really Old Guy sleeps all the time, his room is a peaceful place for the interns to eat lunch and escape anyone who might bother them. Izzie sits in a chair to Cristina (moving a book in the process), and Cristina asks her what she's doing. Izzie starts to answer that question by griping about how she's not allowed to do anything, but Cristina tells her, "If you want to socialize or talk about your day or get in a quick therapy session, go do it over there." And she points in the general direction of Meredith and George. Izzie thinks Cristina is joking, but she's really not. Alex brings up the woman with two uteruses, and George defensively tells him that since he (Alex) is doing nothing but scutwork for Mark, he's really in no position to mock Alex. But Alex actually has a question about the patient's medical condition, causing George to wonder why he cares. Alex, being a manly man, must deny that he cares at all. George tells Meredith that he called Callie a pig, causing giggles in Alex and Izzie. Meredith asks why he was speaking to Callie at all, since they made a pact to ignore the objects of their affections and focus on work. She decides that since he spoke with Callie once, she can speak to Derek once. Izzie tries to talk about how much things have changed, but nobody is really paying her any mind. And then Meredith calls "gin" in her card game with George and walks out. Izzie wonders what's going on with Meredith and George (what with the whole "swapping opportunities to speak with Derek and Callie"), and he tells her that he and Meredith have a "thing." Izzie's upset that they have a thing that she doesn't know about, and Cristina pitches a fit because everyone is talking in Really Old Guy's room.
Mrs. Pruitt throws back the curtain around her husband's bed and starts yelling at a nurse about the fact that they're late with her husband's medications. Cristina runs into the room to intercede and is pretty short in asking the nurse to go to the pharmacy to check on the meds. Mrs. Pruitt apologizes for losing her temper, and Cristina tells her, "You are just looking out for your husband. You do exactly what it takes to protect him, and that does not make you horrible. It makes you smart." You keep telling yourself that, Cristina. Whatever it takes to get you through the day.
Cut to Cristina walking down a corridor. She gets to the surgical board and decisively walks up to it and erases Bailey's name from the Humpty Dumpty surgery. Commercials.
In Noel's room she's bent over her bed breathing very hard. George is there, and when Addison enters he gives her the update on Noel's condition. Apparently, one of the babies is either trying to get out or is in some kind of distress. Noel is freaking out that Greg is not there. She insists that she can't have the baby without Greg there and then she has some horrible cramping. Addison and George get her into bed and try to calm her down.
Joe's bar. Derek and Nancy are eating lunch. She asks Derek to tell her about "the slutty girl," and at his angry look changes it to "slutty intern." He tells her that it's the "slutty" part he doesn't like. Although he clearly didn't object to it in the beginning. Derek tells Nancy that Meredith is none of her business. She keeps pressing, and he keeps shutting her down. Nancy: "Wow. I've never seen you like this over a girl. Even Addison." He tells her that he's never been like this over a girl, "especially Addison." Nancy thinks Derek is just being bitter, since all Addison did was sleep with Mark. Nancy: "I mean, who hasn't gone there once or twice, right?" He asks her what she's talking about, and she responds, "Come on, everybody sleeps with Mark. It's practically a rite of passage." Wow. That sounds a lot more fun than a bar mitzvah. Although I bet the presents aren't as nice. Derek draws himself up in the most offended and self-righteous pose and acts as though he can barely look at his sister. Nancy says that Addison just made a mistake and Derek tells her that Addison was with Mark for months. That's news to Nancy. Derek tells her to shut up and eat her lunch, and she actually seems inclined to do just that.
Cristina sits on the stairs, guarding the surgical board and continuing to study for the Humpty Dumpty. Meredith sits down to her and tries to start a conversation about Nancy. When Cristina doesn't respond, Meredith asks her if she's mad about something. Cristina: "Everything is not about you, Meredith." Meredith clearly cannot comprehend that notion, and she asks what Cristina's problem is. Cristina: "I have bigger things in my life right now." And with that, she walks away. And then Bailey walks by and sees that her name has been erased from the board. She looks like she was just punched in the gut.
Burke and Cristina are about to start the Humpty Dumpty. She gives him a cryptic look and he says, "What?" But she says it's nothing, and he asks for a ten blade.
George walks out of Noel's room to look for...something, and he finds Greg. Greg wants to know how Noel is, and George yells at him for letting Noel think that he left her. But Greg is feeling pretty confused and is clearly not sure that he hasn't left Noel. George yells at him some more and then tells him that Addison is about to perform an emergency C-section to deliver one of the babies and, with luck, stop delivery of the other (which is six weeks younger and not really ready). Greg asks whether she's delivering the boy (the one that is his) or the girl (the one that is not). George looks at him and yells, "Greg! Ham or eggs!" George leaves, and Greg goes back to his fuming over what to do.
Alex is at a nurses' station doing research on the whole two-uterus thing on a laptop. Mark walks up behind him and accuses him of not being committed to a career in plastics based on the fact that he was unwilling to spend his time on hold with the DMV for Mark. So does Mark have any redeeming qualities? I mean, other than the body? Alex doesn't think that being on hold with the DMV has anything to do with plastics, but Mark tells him it does because it makes Mark happy and he has the power to make or break a career in plastics. I don't care how hot he is, his personality is way too fucking ugly for me to be attracted to him. Alex picks up Mark's cell phone and redials the DMV. And then a nurse delivers a very stilted line to Hot Male Nurse about Addison needing two units of blood for Noel's C-section. Alex hangs up the phone and briskly walks towards the O.R.
Meredith is dressing Barbri's hand and telling her that the biosynthetic dressing will make it unnecessary for her to have skin grafts. Barbri wonders how long it would add to her recovery if she did need skin grafts. Meredith tries to catch Izzie's eye, but she seems to be very carefully looking off in the middle distance. Meredith tries to answer Barbri's question, and Barbri quickly gets to asking if she would need a more severe burn in order to be put out of commission for a while. Meredith, finally realizing something is wrong, tries to get Barbri to tell the story of how she burned herself. Barbri gets nervous and tells them that she has to go home to study for the burn. I mean, "bar." Meredith is panicking, and Izzie calmly asks Barbri, "Did you burn yourself?" Meredith tries to shut her up, reminding her of Bailey's rules, but Izzie ignores her, telling Barbri, "It's okay if you did." Hey, what do you know -- Barbri did burn herself. She's failed the bar exam five times, and she can't bear the thought of failing again and disappointing her entire family. Commercials.
It's nighttime. Addison is still performing the C-section on Noel. There's quite a crowd gathered to observe, both in the gallery and on the floor of the O.R. She tells George that she's ready to make some incision or other and that his job is to move the top uterus to the side so she can reach the other one. And then she tells him that she has two minutes to get one of the babies out and that if he moves the uterus at all while she's doing that, the baby could easily die. (Which one, I'm not sure.) Nancy is there looking over Addison's shoulder, and Alex is standing nearby as well.
In the other O.R., Cristina and Burke have Mr. Pruitt's heart in a bowl on a table near his body and Cristina is performing the surgery while Burke directs her. They pull this disgusting purple booger of a tumor out of Mr. Pruitt's heart. Nasty, is all I'm saying. Cristina anticipates what the step in the surgery is, and Burke notes that she's been doing her homework.
Back at the C-section, it's all very gross and bloody and amazing until the fetus in George's uterus (I mean, the one he's holding -- George doesn't actually have a uterus, as far as I know) starts to squirm. And then Noel's blood pressure starts to drop precipitously. George and Addison are both getting panicky, and Alex yells at George to talk to the baby. He pushes his way up to the table and Addison tells him to back off. But he is insistent, and when George doesn't start talking to the baby, Alex leans in and delivers a blow-by-blow of the Foreman/Ali fight of 1974. As you would expect, it works -- the baby calms down, and Addison can proceed with the surgery.
In one of the suture rooms, the Chief is using a suture kit to sew a button onto his shirt. Derek walks up to him and tells him that he's giving the button too much slack. The Chief is wearing those magnifying surgery glasses. Heh. Derek starts to kibitz, and the Chief gives up in frustration, telling Derek, "You sew this on for me, I'll get rid of Addison and Sloan." Derek is eager to take him up on this offer, but the Chief tells him he's not serious. But Derek offers to do it anyway. And then the Chief asks if Derek's sister is planning on moving to Seattle and working at the hospital. You know, if his whole family slowly migrated to Seattle, I bet that would convince him to move back to New York. Derek tells the Chief that he really hopes Nancy doesn't move to Seattle. The Chief tells Derek that he knows how hard everything has been on him (Derek). Derek tells the Chief that Mark was like his brother. Which shines a disgusting new light on Mark's sexual congress with Nancy. They talk about how much divorce sucks and how hard it is to just move on and leave the pain behind. Derek asks what's up with the Chief and Adele. The Chief: "I'm sewing on a button for the first time in my life. What's that tell you?" Derek, with a laugh: "Technically, I'm sewing. I'm just saying." In some cultures, Derek and the Chief would be engaged at this point.
Alex walks out of Noel's O.R. Hey, Mark is there. Do you think he's happy? Here's a hint -- he tells Alex, "So we're clear. You knew when you stepped into that surgery you were forfeiting your career in plastics, right." Alex tries to defend himself, but Mark just asks for his phone back.
Mr. Pruitt is wheeled out of surgery, with Burke and Cristina sauntering along behind him. Burke praises Cristina, noting that she was really prepared. Cristina: "Yes, I'm always prepared." He tells her that he couldn't have done it without her, and she thanks him. And then Bailey nervously approaches and asks for a moment of his time. Cristina walks down the hall, but stays in earshot (and in Burke's view). Bailey, with a tremor in her voice, tells Burke, "I didn't realize that you were one of them. One of the doctors around here with doubts about me or my abilities." Burke is surprised to hear this and tells her that he doesn't doubt her abilities. But she points out that her name was erased from the board, and she assumed he made that choice. He looks over Bailey's head (not a difficult chore) and catches Cristina's eye. He starts to say something to Bailey, but she interrupts to tell him that she just needs to know why he did it. He takes a second, steels up his nerve, and tells her, "I'm afraid I just couldn't use you." Bailey takes that in and walks away. Cristina, with what I hope is some shame over what just happened, turns her back on the scene and walks away herself. Commercials.
Derek is doing paperwork in a doctor's lounge when Nancy enters and tells him the two uteruses case was "unbelievably cool." She pours herself some coffee and tells him that she's just about to leave for the airport. He asks what report she's going to give to their mother. Nancy: "That you're you, still running in circles around all the women in your life. But that's to be expected with four sisters and a dead dad." Derek denies running around in circles, and she responds by asking him if he can even remember the last time he wasn't in a relationship. She advises him to get some space by getting away from Addison and the slutty intern. Derek: "Kathleen's a shrink, Nancy, not you." But he's smiling when he says it. Having taken exactly one tiny sip of her coffee, she tells him she has to go and puts her cup down on the table. Boy, it's waste like that that's driving up the cost of healthcare in this country. She kisses him on the cheek and heads out. As she gets to the door, he calls her name and thanks her for flying out to see him.
Izzie, Meredith, and Barbri are in the elevator, which is slowly ascending. Barbri asks exactly where they are going, and Meredith tells her they need to go "upstairs." That's not really an answer. The elevator doors open, and the three of them head down a hallway that is painted in calming, soothing colors. Barbri freaks out a bit and asks them where they are. Mere tells her it's the psychiatric floor; they're going to place her on a 72-hour hold. Meredith and Izzie have made the mistake of walking ahead of Barbri, giving her a chance to run back to the elevator. They join her there before the doors have a chance to close, and she begs them to let her go home. Izzie tells her that they think she'll just hurt herself again so she doesn't have to take the bar exam. Izzie gives a lovely speech about how Barbri needs help, we all need help, and Izzie is happy to have the help she needs right at that moment. Izzie reaches out her hand. Barbri tells her, "I'm not crazy." Izzie: "I know." Barbri: "Just...didn't want to fail." Izzie: "I know." And with that, Barbri takes Izzie's hand and lets her lead her off to Cloud Cuckoo-Land.
In Noel's room, Addison examines her still-pregnant abdomen while George writes on the chart. Noel wakes up and asks what happened: "Are my babies okay?" Addison explains that the surgery went well, the baby boy was delivered safely, and the baby girl is still in its own little uterus. Noel asks if Greg has come back yet, and Addison is sorry to tell her that he hasn't. Noel closes her eyes and drifts off. Addison tells George to give her an update every half-hour. As Addison is preparing to leave, Noel wakes up again and asks, "What happened? My babies...?" Addison gives her the same speech about everything that went down, and Noel once again asks if Greg has returned. The answer hasn't changed. Noel drifts off again, and Addison continues giving instructions to George. And then Noel wakes up again: "What happened?" Man, I thought Day Break wasn't premiering for a couple more weeks. Addison gives Noel the same update on her condition. With tears in her eyes, Noel asks if Greg has returned. This time, the answer is different -- he walks in the door and tells her that he's right there. He sits by her bed. As Noel cries, he tells her, "I saw our son. He's amazing. But how's our little girl?" He puts his hand on her abdomen, and her hand joins his. George watches them, clearly moved. Is he wearing mascara? Or are his eyes just that pretty?
Callie sits, fidgeting over a chart and staring off into space. Mark sidles up to her and tells her that she looks like she could use some cheering up. Callie: "Not from you." She turns her back to him, but he tells her that he recalls being able to cheer her up several times in one night. She tells him it wasn't cheerful, it was dirty. Is there a difference? She tells him "no" again and walks away. Didn't Mark claim to be in love with Addison? And didn't he have sex with her just last episode? And doesn't he realize that it would be very easy for a man of his hotness to find women to sleep with who don't share his place of employment? Mark walks away, and we see that Alex was just on the other side of a pair of blinds during this entire exchange, eating an apple and looking thoughtful.
Derek is going up the Stairwell of Regrets and Recriminations when he meets Meredith coming down. She smiles and tells him, "Your sister really doesn't like me, huh?" Derek blames Nancy's bitchiness on the fact that she's from the east coast. As an easterner myself, I don't know whether to be insulted or flattered by that comment. They look at each other for long seconds. Meredith breaks the silence by starting to excuse herself, but Derek interrupts to tell her that he really should have called her after she dumped the hot vet to be with him. Meredith observes that he didn't call her. Derek: "I want us to work. It's just... it's complicated. I think I need a little time to..." Meredith: "Take some space?" She's hit the nail on the head. She's smiling as she tells him she understands, but there's that little sadness in her eyes that Ellen Pompeo is so good at conveying. The both say "okay" and walk away.
Meredith VO: "There are times when even the best of us have trouble with commitment." Just outside the front door of the hospital, Izzie is getting ready to go home. The Chief walks out behind her. He tells her that he was just looking at Meredith's evaluation of her first day back. Izzie: "I get daily report cards now?" The Chief doesn't deny it, and tells her that it was a difficult case. In some universe where all doctors are stupid and insensitive, maybe. Also, did she just handle one case her entire first day? That must be the cushiest internship ever. The Chief tells Izzie that she did a good job with Barbri. Before he walks away, he tells her, "Welcome back, Dr. Stevens." Izzie looks to be near tears.
Callie leans against a wall. She's clearly waiting for George, because when he walks off the elevator, she approaches him and apologizes for being rude to him earlier. She also tells him that she understands the whole pig metaphor and that he's now claiming to be committed. She continues, "Only we broke up. And I've been wanting to hear this from you for how long? And you wait until now to say it to me, after we've broken up?" She goes into a rant about how she is a happy, independent, single woman, but when George says "things like this, it makes it too hard." And then she winds it up: "So please, don't chase me anymore. Unless you're ready to catch me." George hasn't said a single word, and Callie walks away. And I don't see George chasing her. Mere VO: "And we may be surprised by the commitments we are willing to let slip out of our grasp."
Cristina is in the empty locker room, looking utterly bereft of happiness as she stares off into space. Meredith walks around the corner and is standing behind Cristina. Meredith: "I'm here for you, whatever it is. Whenever you're ready, I'm here." You know, Meredith is often wrapped up in her own little world, but she is also a very good friend. I really like that about her. Cristina thanks her, but clearly isn't ready to talk yet. Meredith leaves. Mere VO: "We may surprise ourselves by the commitments we're willing to make."
Cut to Cristina writing on the surgical board. Mere VO: "True commitment takes effort. And sacrifice." The camera pulls back, and we see Burke watching Cristina write on the board. They catch each other's eyes, and there is nothing but recriminations in that look. Y'all, this secret is a tumor in the heart of their relationship. Somebody's going to have to perform a Humpty Dumpty before too long, and once that heart is taken apart I have no idea if anyone will be able to put the pieces back together. Burke walks away, and Cristina goes back to writing on the board. And then Bailey carries some files to the nurse's station. She glances over at the board, and then looks again when she realizes that Cristina is writing on it. Mere VO: "Which is why, sometimes, we have to learn the hard way to choose our commitments very carefully." There's a slowly dawning look of realization on Bailey's face. Credits.