After four deaths in the morning, every doctors' personal superstitions and rituals come into focus. And the belief is that three more patients will die before the day is done.George continues to ignore Meredith but Callie seems to have lost patience with him as well, since he hasn't called her yet. Meredith and Bailey deal with a woman who claims to have been struck by lightning but clearly wasn't. Cristina has to deal with a patient with OCD who suffered a head trauma.
And Izzie and Alex turn their attention to a fading Denny each for their own reasons. Richard doesn't believe in any of the foolishness regarding surgical superstitions, but there's a ritual of his own he's been neglecting when his AA sponsor checks in with a serious condition, we learn that a) Richard is a recovered alcoholic and b) he hasn't been to a meeting in a while. As Izzie worries that Denny will be one of the seven, Alex is a little too blunt with him, and that results in their break up, which leads Alex to blow up at George and then George to finally make a move with Callie.