After a round of steamy (sadly, off-screen) fireside love-making, most guys would roll over and fall asleep. Not Dr. Derek Shepherd. He’s too busy figuring out a way to remove Izzie’s tumor. Wasn’t that supposed to be inoperable? Again, not for Dr. Derek Shepherd.
Dr. Swender isn’t sold on Derek’s plan to operate. The surgery is risky and the IL2 treatment Izzie is getting has kept another “miracle” patient tumor-free for two years. Izzie is also worried about the speech and memory side effects of surgery. The debate begins. Surgery or radiation? Yeah, we don’t know what they should do either.
They do some tests to see how Izzie's memory might be affected by the surgery. During the testing, she's unable to speak, or even nod, when Meredith asks her to tell her who Alex is. Needless to say, the test doesn’t do much to convince Izzie or Dr. Swender. Even Meredith is switching sides. Alex, on the other hand, asks Derek, “What if it was Meredith?" Derek tells him, "I would ask her to have the surgery."