Owen brings in a former Army colleague, Teddy Altman, as the new cardio attending, as a "gift" for Cristina. But Cristina is unimpressed with Teddy's credentials and dubs her "Desert Storm Barbie." But when Teddy diagnoses a boy as having cardio asthma, and lets Cristina call most of the shots during the surgery, Cristina is won over. We see trouble for Owen and Cristina, however: Teddy confesses she always had feelings for him and we can see he's giving the idea some thought! And we also know that Jackson is waiting in the wings for Cristina.
We can't believe it when Izzie returns to Seattle Grace, not to ask for her job back, or to hash things out with Alex, but to get a diagnosis for her high school teacher, who is suffering from dementia. She bullies Charles into doing a series of tests, including a spinal tap, telling him, "You got me fired. You owe me this, bitch." The teacher's illness ends up being treatable, but he can't afford the $10,000 surgery. Izzie marches into Richard's office and demands that he do the surgery pro bono, or she'll go to the press about how she gave the hospital $8 million for the clinic.
Of course, we're really dying to know: What will Alex say when he sees Izzie? We're shocked when he pretends he hasn't even seen her! When he finally confronts her, we can see that any reconciliation is a long way off. Izzie tells him, "You went behind my back and told the chief I wasn't ready to be here. You got me fired." She says, "I cannot forgive you for this." We can't blame him that he's furious about her disappearing act: "I am your husband and you didn't give me the benefit off the doubt, so you know what, I can't forgive you either."
When the Chief starts spending night after night at the hospital, Adele assumes the worst. We laugh at Miranda's reaction when Adele asks her, "Are you having an affair with my husband? You're more married to that man than I am." Callie helpfully explains that Richard is Miranda's "work husband" and that she's his "work wife." Adele accepts Miranda's promise that she is not the one sleeping with her husband, but now Miranda is on a mission to find out who the other woman really is. We're in disbelief when she confronts the Chief and tells him she knows it's Izzie! "It's why you ignored the DNR, it's why you fired her, it's why you two were screaming at each other in here," she says. Richard explains that he's not having an affair, he's simply got too much on his plate. In fact, he's handing over all his surgeries to her, effective immediately! This is after he's committed a serious error during surgery—one his "work wife" fixed and kept a secret.
We're assuming that Richard's just married to his job, but we're shocked when we learn the truth: He's been drinking! It explains everything: His mismanagement since the merger, the car accident, and the surgical error. We wonder what Meredith (who's back at work) will say to Derek about her suspicions.