All of the boys except for nasty McSteamy go camping (including Joe and Walter). Alex tells George about Callie sleeping with McSteamy, leading to the two of them having the worst slap fight ever. During the slap fight, Walter gets knocked over and hits his head on a rock. While Burke is stitching him up, George realizes there is something up with Burke's hand. McDreamy realizes all of the boys are a bunch of idiots, and they go home after one day of camping.
Back at the hospital, it's all girls all the time, except for nasty McSteamy. Meredith joins him in treating a pre-op transsexual who is diagnosed with breast cancer just before the surgery that will transform her penis into a vagina. The patient insists on going forward with the surgery, even though it endangers her life. McSteamy tries to suggest that Meredith should dump McDreamy, but the example of the patient's wife maybe helps Meredith realize she still wants to be with him. Callie and Addison work together treating a pregnant patient who fell and broke her arm. The fall also caused the death of the baby she's carrying, leading to lots of tears and some bonding between Callie and Addison. Bailey knows something is up with Cristina, and won't let her in any surgery until she confesses why she erased Bailey's name from Burke's surgery last episode. As a result, Cristina spends the day sorting through the feces of a little boy who ate an entire Monopoly set. Izzie is required to spend the day with a "peer counselor," who ends up being the scary cheerful resident who supervised the interns while Bailey was on pregnancy leave. When George returns to the hospital, he starts to confront Callie about the McSteamy sex, only to hear that his father is in the hospital as a patient. Finally, after McSteamy makes a move on Meredith at the bar, McDreamy arrives, and he and Mere decide to start their relationship from scratch.
Previously, on Grey's Anatomy, Izzie returned to the hospital, Derek and Addison finalized their divorce, Derek decided to take a little space away from women, Callie dumped George after having dirty sex with McSteamy, Alex overheard Callie talking about the dirty sex, and Bailey realized that something was up with Cristina and Burke.
Burke oh-so-obsessively rolls up some shirts and stuffs them in a backpack while Cristina watches. Meredith's voiceover tells us, "As surgeons, we're trained to look for disease." I thought it was the non-surgeons' job to look for the disease and the surgeons' job to fix the disease via bodily cutting. Cristina: "You're going camping?" Indeed he is -- with McDreamy, no less. For Cristina, "camping" equals "everyone peeing behind the same bush." Remind me not to invite her on my camping trip. Mere's V.O. tells us that some diseases are easy to spot, but some are very hard to detect. Cristina tells Burke that she's booked the O.R. for a couple of surgeries that day, but he tells her that he went ahead and canceled them. Cristina doesn't understand why he canceled the surgeries or why he's going camping.
Derek opens the back door of his...vehicle. It looks kind of like a jeep and kind of like something the Australian army would drive to fight off a kangaroo invasion. Derek is sooo excited to be heading off to the woods with Burke. He even describes the two of them as "mountain men in the wild." This is when I started hoping for a little Deliverance action in this episode. Mere's V.O. is going on about diagnosing disease -- for once, it's utterly irrelevant to the episode, so I'm just going to ignore it. As they get in the jeep-thing, Burke tells McDreamy that they have to make one stop.
Cut to the Chief approaching the jeep-thing, pulling a rolling suitcase and carrying a fancy pic-a-nic basket. He is also excited about being a mountain man in the wild. Derek's enthusiasm has dropped off somewhat. The Chief hands his little rolly case to McDreamy and notes that it's his first camping trip. I thought that by law all Seattle residents were required to spend a fortnight in the woods each year. Derek asks Burke if he has any other surprises.
Surprise! We're at Casa Grey, where Izzie is making sure that George has packed everything he needs. I bet she sewed his name onto the back of his underwear, too. George tells her, "Izzie, I'm not five. Zip me?" Heh. George tells Izzie that if Callie calls, she should tell her that he's a mountain man. Burke whispers to Derek that he invited George (implying, I guess, that the Chief invited himself). George tells the fellas that Izzie baked them some treats. Derek does not look happy. Which is just crazy, because I bet Izzie makes the best treats. As everyone leaves, we see that Meredith is leaning against a wall. She tells McDreamy, "Have fun with your space. Or whatever."
Our merry band has arrived at Joe's bar, where Joe and Walter are packing their backpacks. First, yay for Walter! We haven't seen him since last November. It's like a glorious Thanksgiving tradition. Second, why are they packing at the bar? Do they live there? (I can't decide if it would be super-pathetic or super-cool if that's the case.) George is explaining to Derek that he asked Joe if he could borrow a tent and there was a misunderstanding. And then Alex walks in with his pack. George tells Derek, "That wasn't me. I swear." McDreamy gives Burke a look, but he just shrugs in return.
We get some footage of gorgeous mountain scenery and then cut to the Surgical Scouts tramping across this suspension footbridge that is freaking beautiful. They love to go a-wandering. Val-deri, val-dera, val-dera-ha-ha-ha-ha-ha.
Back at the hospital, Addison is eating breakfast at a table in the doctor's lounge while reading a magazine. She's wearing these awesome glasses. I think those glasses just turned me straight for two seconds. Although now that I think about it, maybe straight men don't lust after accessories. Callie is also in the lounge, eating cereal and looking at patient charts. And then McSteamy walks in. He makes eye contact with Callie and then makes eye contact with Addison. And then Addison and Callie make eye contact with each other. Although I'm not sure if anyone's making eye contact with Addison or if they're checking out her glasses.
Meredith, Cristina, and Izzie contemplate the surgical board. Meredith moans about McDreamy taking time and space while camping. Cristina thinks someone named "Preston" should not be going into the woods. Izzie thinks it's all just a glorified slumber party. Do you think George and Alex will do each other's nails? Or practice kissing? Mark walks up to them and asks if they've seen "what's-his-face." Izzie tells him that the name is "Alex Karev." Mark tells them, "The poor bastard seems to get a thrill out of tagging along after me." Mere tells him that Alex is camping, and Mark asks her, "Well, in that case, how'd you like to get a thrill tagging along after me?" Why didn't they take him camping? And drop him off a cliff? Meredith tells him that Bailey makes the assignments. (Except, apparently, when Cristina is assigning herself to all of Burke's surgeries.) Bailey approaches at that moment and tells Mere that she's happy to assign Meredith to work with Mark. Meredith leaves, and Bailey takes her spot in the line-up of female charm and beauty. Bailey tells Izzie to go to the conference room, as she is required to spend the day with a peer counselor. Izzie complains that she's now being required to see a peer counselor on top of the shrink already assigned by the hospital. Bailey just tells her to go and be counseled by her peer. Bailey points out to Cristina that there are some really exciting procedures on the board that day. Cristina excitedly asks which one she should start with.
Cut to an x-ray of someone's abdomen. There are all kinds of little boxes floating around in the abdomen. Oh, they're Monopoly pieces. The little boy whose x-ray it is tells them that he swallowed twenty-one Monopoly pieces (including the thimble, race car, and shoe). His mother is there and she tells us that the little boy (whose name is Eric) swallowed the pieces while fighting with his brother. Eric's brother wouldn't let him play, so Eric swallowed the pieces so that nobody could play. Bailey asks Cristina what she would recommend for treatment, and Cristina asks, "Is this even surgical?" But Bailey insists, so Cristina tells her that she would track and inventory all of the pieces via periodic x-rays, and "keep examining the stool." Bailey tells her that she's exactly right, and then tells her to enjoy herself. I'm sure she will.
Out in the hall, Cristina runs after Bailey and asks if a nurse shouldn't really be going through Eric's crap. Bailey: "Are you too good to help that boy?" Cristina: "Yes." But then she sees Bailey's withering stare and changes her answer. But she did think that she would be more help if she could assist Bailey in a surgery. Bailey: "No surgeries for you." Bailey walks away, and Cristina follows after, telling her, "I don't understand." Bailey: "I don't understand why you erased my name from the O.R. board." Cristina tries to deny it. If Cristina were Gaius Baltar, Bailey would start torturing her right about now. (Bailey would make a kick-ass Cylon.) She doesn't, but she does tell Cristina to cut the shit. Or, you know, examine it. She also tells her that until she tells Bailey why she did it, she's not getting any surgeries.
In the elevator, Meredith is telling McSteamy that if they're going to have a "friendship thing, or whatever," there are rules. What the fuck? She has to work with him, because Bailey told her to -- but why would she want to be his friend? He calls her a member of the "dirty mistresses club," which totally deserves a major slap. Or punch. Or kick in the crotch. Oh hell, let's give him the trifecta. Meredith's rules are that he can't flirt with her, can't talk about Derek, and can't give her "the face." She's talking about "the McSteamy face," to which she claims to be immune. He tells her, "You know, if I'd gone camping I'd have taken you off to the woods to keep me warm." He smiles at her, and she accuses him of breaking all three rules. When is someone going to punch him?
Izzie enters the conference room, where she is greeted by our old friend, Sydney, the resident who took over for Bailey while she was out pregnant, and whose philosophy is "heal with love." Izzie is totally nonplussed. When she calls Sydney a "counselor," Sydney corrects her: "Peer counselor. We're equals." And then she hugs Izzie. When Cristina has her inevitable crash and burn, I really, really hope Sydney is her peer counselor. I will give anything to make that happen. During the very long hug, Sydney asks how Izzie is doing. Izzie claims she's fine, and Sydney tells her, "Now that is outside Izzie talking. How's inside Izzie?" And she lovingly places her hand on Izzie's chest. Izzie has no idea how to respond.
Meredith and Mark exit the elevator. He wants to know if she and Derek are together. He tells her, "Just answer the question and I'll stop asking it." And he makes that sound like some big concession, but don't most people stop asking a question once they've gotten an answer? Meredith tells him that she and Derek are taking space. He wants to know exactly what that means, and she tells him, "Derek and I...there's just a lot of water under the thing, or whatever." And then they enter a patient's room.
In the room are two pretty young women, unpacking their bags. Or the bags of one of them. Mark greets them as Donna and Vicky, and asks how the flight was. Donna says it was fine, but Vicky is clearly not happy. Donna tells Mark that Vicky is having "penis issues." I'm sure McSteamy is familiar with those. Meredith has no idea what's going on here, asking "Am I missing something?" Vicky tells her, "I believe that what you're missing is that Dr. Sloane is planning on removing my husband's penis this afternoon." Meredith asks where that husband is. The husband, of course, is Donna. In Meredith's defense, I've spent a fair amount of time around a number of male-to-female trans people, and I didn't pick up on Donna's masculinity right away either. Non-credits.
Back in Donna's room, Meredith is reading from the chart. She calls Donna "Daniel," and Mark corrects her. Meredith continues to struggle with the pronouns, and Mark gives her shit. But Donna and Vicky both think she's doing fine. Vicky: "Better than I did when I first found out." Mark tells Donna that there are some pre-op labs they have to take care of, and then they can perform the surgery. He's very warm and comforting with his patients -- I like that he's not an asshole to everyone.
Out in the woods, McDreamy admires all the natural beauty around him. And then he looks over at their campsite, where George is scampering around to put together a fire pit, Alex is clumsily trying to set up his tent, and the Chief is having some brie and crackers from his picnic basket. George admires the basket -- the Chief tells him that the concierge at the hotel put it together for him. George walks away from the Chief, and Alex busts on the Chief for being namby pamby. But George doesn't think Alex is too tough, noting that he's woefully underdressed. Alex thinks he'll be fine. George: "Just do me a favor -- don't come crawling to me in the middle of the night when you want to huddle for warmth." The Chief, sitting in his little camp chair, admires Joe's tent and asks if he and Walter have room for a houseguest. Or tentguest. Joe suggests that the Chief would be happier with one of the other doctors, but the Chief notes that Burke is already sharing with George and Alex and Derek's tents are "pretty puny." Joe tells the Chief that he and Walter were kind of planning on being alone, but the Chief doesn't take the hint so Joe caves and invites him to share their tent. Alex tries to tell the Chief it's not really a good idea, and George leans into him and says, "Chief? They want to be alone." And then the Chief sees Joe put his hands around Walter's waist as he whispers to him. It takes a few seconds, but the realization finally dawns on the Chief: "Ooooh. So you are um... That's wonderful. Man love. It's beautiful. It's beautiful. My cousin's gay." Not to mention your dear friend Lloyd Mackey, who made a move on George. The Chief keeps embarrassing himself, saying things about Brokeback Mountain, until Burke rescues him by suggesting they all go fishing.
Cristina is looking over another x-ray of Eric's tummy when Meredith tells her about the sexual reassignment surgery she'll be performing. Except she calls it "removing a man's penis." Cristina is upset: "That should be my penis." And then Izzie walks up to them and yells, "I have to hide!" She's desperate to escape from Sydney. Meredith and Cristina both look blank until Izzie calls her "'Heal with love' Sydney." And then they make "ew" sounds. Izzie can't stand the thought of shadowing Sydney and "dialoguing" with her, and she begs the two of them to help her find a reason to skip out on that. Cristina looks like she has an idea.
Cut to Izzie in the toilet of Eric's room. She has just sorted through some crap for Monopoly pieces. She announces her findings: "A couple houses and the dog." She is very disturbed to see the poor little dog covered in poop, since that's the piece she always uses when she plays.
Addison is in an exam room with a very pregnant young woman and her husband. The two of them are very affectionate. Callie walks into the room, having been paged. The pregnant woman, named Jamie, slipped and fell in the shower. Addison performs an ultrasound while Callie examines Jamie's arm, which is broken. Jamie screams and moans when Callie examines her arm -- she has refused any pain medication even though Addison has told her it would be safe for the baby. Jamie is worried about the baby, since he was kicking quite a bit and she hasn't felt anything since the fall. Addison, looking at the ultrasound, tells her it's likely the baby is just sleeping. While Callie explains to Jamie how they're going to treat her broken arm, Addison looks at the ultrasound. There is no movement at all in Jamie's uterus. Addison, clearly a bit upset, excuses herself from the room.
Meredith looks over some paperwork in a waiting room, and Vicky offers to trade her for the insurance forms she's filling out. Meredith notes that Vicky is handling things pretty well. Although if the surgery goes as planned, soon there won't be anything to handle. Vicky confesses that she left for a while after her husband started to turn into a roommate. Meredith points out that she came back and asks why. Vicky: "Honestly? Right now, I have no idea." They each return to their paperwork, and Vicky tells Mere, "I'm really gonna miss the penis."
Callie walks into the women's bathroom. There are crying sounds coming from one of the stalls. Callie bends down and sees Addison's shoes. She asks if Addison is okay. Addison's sobs make it hard to accept her claim that she's fine, and Callie tells her, "Don't make me climb over this stall. I'll do it, but I'll be really pissed, 'cause I don't know you that well." Addison opens the door. She's crouched down on the floor crying, and Callie astutely notes that she is not, in fact, okay. Callie extends her hand, and Addison stands up. Addison walks over to the sink and notes that she's used to "this" and it shouldn't affect her the way it has. Callie asks what it is she's used to, and Addison tells us that Jamie's baby died when she fell.
The Surgical Scouts have all gone fishing. You know, a river is running through it, etc. etc. The Chief asks Joe how long he and Walter have been together. It's been ten years, "on and off. Now, definitely on." Walter is sitting on a rock reading a book. A man after my own heart. Joe and Walter are thinking about having kids. The Chief never had any because Adele didn't want to raise them by herself (meaning, while the Chief was spending all his time at the hospital). Joe and Walter have had the same issue because Joe works so much at the bar, but Joe's willing to make a change for Walter, because he can't imagine life without him.
Burke praises George's casting ability. As you might guess, George did a lot of fishing with his father and brothers when he was growing up. Burke asks how things are going with Callie. George tells him, "Good. She doesn't know it yet, but we are. Excellent, even." That's because George is finally ready to be the pig and commit to the relationship. Alex looks on as George talks. And then George asks if Burke knew when it was "the right time" for him and Cristina. Burke claims that he did, but he seems kind of noncommittal about the whole idea. And then George sees Burke's hand shake as he puts a lure on his line. George asks if everything is okay, and Burke tells him he's going to move downstream. Commercials.
Back in Seattle, McSteamy is breaking the news to Donna that the pre-op lab tests have revealed that she has breast cancer. Apparently, breast cancer is a very rare side effect of the hormones she's been taking. Mark tells Donna that they need to stop the hormone therapy and start treating the cancer. Donna asks about the sex reassignment surgery, and Mark tells her that there's really no point in going forward, as ending the hormone treatment will cause her breasts to shrink and her facial hair to grow back. In other words, she'll look like my Aunt Louisa. Vicky doesn't seem crushed at the idea that Donna would become a man again. Donna asks what would happen if she went ahead with the surgery and kept taking the hormones. Mark counsels against it. I have a question -- why not go ahead with the surgery, stop the hormones while you treat the cancer, and then start the hormones once the cancer is treated? The depth of the problem has finally dawned on Donna: "Are you saying that if I become a woman, I could die?"
Addison and Callie watch Jamie and her husband through a window. Addison notes how happy they are; she thinks that "happy people should have happy things happen to them." She prepares to go break the news, but Callie tells her to wait so they can have a few more minutes of happiness together.
Back by the waters of Babylon, Alex asks George if he's really getting back together with Callie. George says that he is, and Alex tells him, "Trust me man, I really don't think you want to do that." George: "So when I get back, I'm gonna tell her that we shouldn't see each other any more. Then when she asks why, I'm just gonna say, 'Well, Alex Karev thinks our relationship isn't such a good idea.' You think that'll do the trick?" Alex tells him to suit himself.
Downstream, McDreamy is casting to Burke. Derek complains about all the interlopers, noting that he was going to come alone. Burke asks the obvious question, which is why Derek invited him to come along. Derek claims that he needed Burke to be there in order to make it "a guy trip." Burke asks Derek, "You don't have any friends, do you?" Derek claims he does. But they all live in Canada, so Burke wouldn't know them. Derek was looking for some peace and some space but Burke invited "half the hospital." The half with penises. (Except for Mark and Donna.) Burke: "That's because I have guy friends." So, George and Alex are his guy friends? That's pretty sad.
Sydney finds Izzie in Eric's room, where she is still going through poop. (Cristina is also there -- it looks like she's practicing some stitching). Sydney is still unrelentingly cheerful. Izzie claims that Cristina needed help with a patient. Sydney looks at Eric and tells Izzie, "Oh, patient care always comes first." And then she sits down to wait for Izzie to finish what she's doing so they can resume their dialoguing.
Meredith asks Mark, "So, what happens to Donna now?" Mark: "She goes back to being an unhappy man who's stuck with a penis. There are millions of us out there." I know at least some men are happier when they're stuck with a penis. Meredith asks Mark if he's unhappy with his penis. He tells her that he could be a lot less unhappy with it. I think she should offer to remove it for him. And then Mark tells her that it's probably good that McDreamy is taking some space, as it might be a sign that the two of them aren't meant to be together. Mark tells Meredith that Derek is "damaged goods." He continues, "It's my fault, I damaged him." And he's going to try to damage him some more by sleeping with Meredith. And then Vicky comes out to tell Mark that he needs to speak to Donna, who has decided to go ahead with the operation.
Back at the river, the Chief is now standing with Burke and Derek. He tells them that Joe and Walter got tired of not catching any fish and decided to go for a hike. He's curious why they aren't catching any fish, and Derek tells him that it's because he can't stop yapping. Upstream, George starts to ask Alex if he's noticed anything odd about Burke, but then he catches sight of the end of Alex's rod and gets very excited. As one would. George asks Alex, "What are you doing?! You don't use bait when you're casting. It's gonna fall off before it hits the water." George gets the tackle box to find a lure for Alex, and Alex tells him, "She's sleeping with Sloane, dude." George doesn't think that's true, but Alex keeps repeating it. George drops the tackle box and tells him, "You'd better take that back." Downstream, Derek is telling the Chief that all the people "chatting, laughing, moving around" are keeping the fish away. He and Burke continue their argument about Burke inviting other people, while in the background we see George shove Alex. After a second the others notice, and the Chief runs over to break it up. Commercials.
Back in the Hundred Acre Wood, Piglet and Tigger are about to throw down. Everyone is back at the campsite, and the Chief tells our lovable scamps that while he detests fighting, if George and Alex are going to fight they are going to do so in a way that doesn't endanger their surgically gifted hands. And that way is "open-handed combat." George and Alex, simultaneously: "A slap fight?" The Chief also tells them there will be no scratching, biting, or wrestling moves. Derek and Burke are watching; Derek thinks the fight is ridiculous because Alex will demolish George, while Burke is less certain. He thinks George is "a scrapper." Or maybe a fart -- he calls him "silent but deadly." He also thinks that the fight is a good way for Alex and George to let off some steam. Burke thinks that Derek's inability to appreciate the manly art of slap-fighting is why he doesn't have any guy friends. Derek thinks it's just further confirmation that he should have gone camping alone. The Chief has finished giving the rules, and George and Alex prepare to fight.
Back at Seattle Grace, Mark is trying to talk Donna out of going ahead with the surgery, but she insists that if he doesn't do the surgery she'll find someone else to do it. Mark: "Donna, listen to me, I am trying to save your life." Donna: "As a man. I am not a man. I'll fight the cancer. I'll just fight it as a woman." This is too much for Vicky, who shouts out, "For God's sake, wake up Daniel!" The only response she gets is "My name is Donna." Vicky refuses to stand by and watch Donna kill herself, so she grabs her coat and walks out. Donna: "I need Vicky to love me. But I need her to love me."
Back in Jamie's room, Callie is just about finished putting a cast on Jamie's arm. Jamie and her husband are still smiling and laughing, even though Jamie's in a lot of pain. As she finishes with the cast, Callie gives a tiny nod to Addison, who walks over to Jamie's bed and tells the two of them that she has to speak to them about the baby. Jamie and her husband both move immediately to a state of high anxiety, which makes me think that they suspected the worst from the beginning. Addison hesitates, and Jamie tells her, "You have to say it. I won't believe unless you say it." The camera pulls back before we actually hear Addison say it.
Back in Eric's room, Izzie and Cristina sort through another stool sample while Sydney sits in the corner. Cristina is blaming Izzie for drawing Sydney to the room, but Izzie points out that she was willing to paw through crap in order to get away from Sydney, so it's hardly her fault. Sydney smiles at them from across the room and asks how it's going. Cristina: "Okay, I can't have that grinning puppet head stare at me another second, so just go." After some complaining, Izzie tells Sydney they can leave. Sydney: "Okie dokie, smoky." After they leave, Eric wheels his I.V. stand over to Cristina and tells her, "Man, I thought my brother and I had problems, but you two are morons." Cristina thinks that eating a Monopoly set wasn't exactly a sign of Eric's genius, but he points out that as a result he'll get to play all the Monopoly he wants in the future. Eric: "I get to play. That's all that matters, getting to play." Cristina asks if that really makes him smart. Eric: "You're fishing through my poop. How smart are you?" Hey, she's fishing through poop with a degree.
Back at the Bungle in the Jungle, Alex and George are "fighting." I think I recognize this style of combat; the Shaolin monks call it "Prissy Boy Style." Burke is calling out tips to George, Derek is complaining about how stupid it all is, and the Chief is refereeing. At one point, Burke tells Derek that the fight is over the fact that Alex told George that McSteamy was doing it with Callie. Joe and Walter return from their hike and look pretty amazed at what they see in the campsite. Walter turns to Joe and tells him, "time, we're not going camping with straight guys." At that moment, Alex grabs George and shoves him into Walter; Walter falls, and on the way down, his face hits the rocks George piled up to make a fire pit. The doctors all rush into action. Commercials.
Meredith is studying some big books and Cristina walks up to her and tells her, "So basically, you're getting paid to look at penises all day?" Meredith is studying up for Donna's surgery, of course. With a slightly lascivious look in her eye, Cristina asks, "You like McSteamy?" Meredith says that she does, but then clarifies that she doesn't like like him. But she is mulling over the points Mark raised about Derek having lots of baggage that Meredith might be better off without. Meredith thinks that in his own sick, twisted way, McSteamy may be trying to protect her. I think he's trying to protect her from the heartbreak of never having sex with him. It's kind of like the heartbreak of psoriasis, but there's a lot less itching. Cristina takes a couple of steps away, and then asks why Meredith didn't tell anyone when her mother was first diagnosed with Alzheimer's. Meredith: "She asked me not to." Cristina asks if Meredith thought it was right to keep her secret. Meredith did indeed. Cristina mutters, mostly to herself, "Even if it meant you had to fish crap out of a toilet all day and probably for years to come." Meredith asks her to take a step back and explain who's secret she's keeping. But Cristina's pager goes off, and she runs out.
Cristina runs into Eric's room. He's started vomiting. His abdomen is rigid and there's blood in the vomit, so she asks Hot Nurse to page Bailey.
Back at Lake Hobegon, everyone is clustered around Walter, who's sitting in the Chief's camp chair. The cut on Walter's forehead isn't deep, and Burke says they can stitch it up using a fishing hook. He explains that a properly prepared fishing hook makes a great needle, but my question is what are they using for thread? Joe is very sweet and loving with Walter as they prepare for the stitches. The Chief offers Alex the chance to do the stitches, but Joe insists on having an attending do it. Personally, if I were to get a gash in my forehead, I'd rather not have it be treated by the guy who gave me the gash in the first place. Burke very slowly threads the needle. George looks at him and tells Joe, "Don't worry. Dr. Burke's really good at doing this." And then he asks Burke, "You are, right?" Burke agrees that he is. And then he starts stitching up Walter's pretty, pretty forehead. If there's a scar, I will never forgive these idiots. Of course, we probably won't see Walter again until November. George watches with concern in his eyes. As Burke finishes, Derek asks if he's got it. And Burke tells him, "I always have it."
Bailey is scrubbing in for a surgery as Cristina stands by expectantly. Bailey asks what Cristina wants. What she wants is to scrub in on Eric's surgery, since he is her patient. Bailey asks again why Cristina erased her name, and Cristina denies any knowledge of said erasure. Bailey: "You really want to go head-to-head with me, on this? You really want that? Right now, this second, in this moment, you chose your own fate." Oooh, it's like a Choose Your Own Adventure book. Cristina should flip back a few chapters and see if she can make some better decisions. Bailey enters the O.R.
In the gallery, Izzie and Sydney are the only two people observing the surgery. Sydney: "So, tell me about Denny?" Izzie is shocked by the request, but Sydney thinks it will help to discuss what happened. Izzie: "Okay, we're done." Sydney thinks she really needs to share, but Izzie tells her that she would rather sift through feces than talk to Sydney. Well, that finally got Sydney to stop smiling. Izzie starts to leave the room and Sydney tries to tell her that she understands what she's going through. Izzie: "You understand? Really? What, you cut someone's LVAD wire and fell in love with the man and he died?" That exact thing didn't happen to Sydney, so Izzie thinks she can't possibly understand what Izzie is going through. You know, can we just assume in the future that if someone in a television show or movie says "I understand what you're going through," it's because they actually went through something similar? It would avoid a lot of arguments. Izzie leaves.
In Donna's O.R., Meredith is telling Mark what the step is in the penis-removal surgery. She's surprised he agreed to go ahead with the surgery. He tells her, "People don't come to me to fix what's on the outside. They come to me to fix what's on the inside." And he does that by changing what's on the outside. Except, you know, that's not really a change now, is it? Mark tells her that when a patient asks for help, he doesn't run or hide or take space.
Out in the woods, the Chief sits in a chair facing Alex. Alex claims that he didn't start anything, and then tells the Chief that he came out to the woods to have fun and George started insulting his clothes and fishing technique. So he just can't stand the fact that George is butcher than he is? And then we get a little backstory on Alex (finally!): he grew up in a bar, where his father was always either playing music or drinking. He saw the camping trip as his chance to just hang out with the guys. I would assume he hung out with the guys when he was a wrestler, but maybe they all hated and shunned him. They both look over at Joe and Walter and agree that they're a happy couple. The Chief: "I miss my wife."
In a different part of the campsite, George and Burke are sitting to each other. Burke tells George that he (George) has high standards. George thinks the same is true of Burke, but Burke clarifies: "Your standards are too high." George puts people up on a pedestal and then attacks as soon as that person makes a mistake. George starts to say something about Cristina, and Burke cuts him off: "Cristina and I are a team. We are a team. You're either part of a team or you play alone for the rest of your life." George walks away.
Back at Seattle Grace, Jamie is having to deliver her dead baby. It's incredibly sad and tragic and there's really nothing more to say about it. After the baby is delivered, Addison swaddles it and places it in Jamie's arms. Let's all use this commercial break to dry our tears and splash a little cold water on our faces.
Back in the woods, Derek fishes in the river while Burke and the Chief stand nearby. The Chief makes a "go ahead" gesture to Burke, and Burke asks Derek, "So, that Mark Sloan. He's bad news?" Derek calls Mark a cancer that affects everything. He thought that if he got out of the city for a while he would get some answers, maybe a fresh start. The Chief doesn't think there's any such thing. Derek asks if the Chief has any other words of wisdom. The Chief acknowledges his own lack of wisdom by pointing out that he lives in a hotel and that his wife won't speak to him. Burke also disclaims any and all wisdom. Derek: "So, in other words, we're all a bunch of idiots." They agree, and the Chief suggests they go home. We get a quick shot of the Surgical Scouts leaving the wilderness to return to civilization.
Sydney enters the locker room and finds Izzie getting dressed. Sydney: "I lost a kid. My first year. It was my fault. And I just couldn't.... So I had a breakdown. They gave me time off, and when I came back I put a smile on my face and everybody thought I was fine. I lost a kid. It comes in waves, Izzie. There's a lull, and then another wave hits you. I wasn't trying to pry. I just wanted you to know it's okay not to be fine sometimes." Izzie: "I miss him. All the time, I miss him. It's not waves, it's constant. All the time. And I walk through the doors of this hospital, and I want to be here, I do, but I don't know if I can be a surgeon again, and I can't talk about it because it scares me too much. Okay?" That's okay with Sydney. Great scene.
Meredith enters Donna's room and sees that Vicky has come back. She got all the way to the airport and came back. She tells a story about dating the first time she left her husband, and how after each date she just wanted to discuss it with her best friend: "And my best friend is Daniel. Donna." Meredith gets it: "She's who you want to talk to."
Meredith's V.O. tells us, "Not all wounds are superficial." Addison and Callie sit on the floor of a hospital corridor. Addison asks if it's true that Callie is sleeping with Mark. Callie: "Was." Addison: "Me too, was." They both agree that sex with Mark was just part of a "hail storm of self-loathing and misery." They laugh, and Addison asks Callie if she wants to get a drink. Callie nods yes, but then her pager goes off. Addison suggests they get a drink some other time. Callie: "Definitely." Could we be heading towards our first girl-on-girl romance among the staff of Seattle Grace?
Through a window, Cristina spies on Bailey telling Eric's mother that he'll make a full recovery. Mere V.O.: "Most wounds runs deeper than we can imagine. You can't see them with the naked eye." Burke walks up to Cristina, and she's surprised to see that he's back. And then she tells him that she's glad he's back.
George sees Callie and walks up to her. She tells him that they need to talk. He's clearly prepared to tear into her over the Mark sex, but she tells him she needs to talk with him about his dad. And then a nurse opens the curtain around a patient and we see George's dad in a hospital bed. Mere V.O.: "And then there are the wounds that take us by surprise."
Joe's bar. Mark is sitting at a table with Meredith. He tells her, "This could be just a drink. Or this could be more than a drink." Why is she drinking with him? He's so obviously not a nice person. And why is he compelled to chase every woman in McDreamy's life? She tells him that she can't start something with him. He tells her, "Start over, Meredith. Start fresh." Honey, I would not call what you're selling "fresh." Mark's pager goes off. He leaves to...find a phone, I guess, although I can't imagine he doesn't have a cell. But maybe it's too loud to make a call from in the bar. He asks her to order him another beer.
Meredith walks up to the bar when Derek walks into the joint. He walks up to her and says, "Hi. I'm Derek Shepherd." And he holds his hand out for her to shake. She asks him what he's doing. He tells her that he wants to start over with her, at the bar where they first met, but taking time to actually get to know each other. He introduces himself again, and she tells him, "You walked away. And now it's too late. There's too much water under the thing, or whatever." Derek: "Meredith. Please." Mere V.O.: "The trick with any kind of wound or disease is to dig down and find the real source of the injury." McSteamy walks back into the bar and Meredith sees him over Derek's shoulder. Derek smiles at her, and she holds out her hand and says, "Hi. I'm Meredith Grey." Mere V.O.: "And once you've found it, try like hell to heal that sucker." Meredith and McDreamy kiss. And kiss some more. Credits.