It seems like Meredith and Derek are finally getting some of that ‘happily ever after’ they always talk about. Derek’s moved in and their relationship is really moving forward. But now that Derek’s king of the castle, his first decree is to banish Alex and Izzie, which doesn’t sit with them, nor with Meredith, very well. Izzie goes so far as to bake muffins as a desperate appeal to Meredith and Derek’s stomachs. Finally, Meredith tells Derek she wants Alex and Izzie to stay and calls them her “family.” (Anything’s better than Thatcher and Ellis, right?) Derek, seeing how much it means to Meredith, agrees.
The Chief does not abide a twelfth-place hospital. As part of sweeping reforms, he lays down some new laws, effective immediately. For starters, residents can’t specialize anymore. Next up, playing favorites (and dating) interns is a big no-no. Finally, he orders his doctors to stop getting so darned attached to their patients. Good luck enforcing those, Chief. You’re going to need it.
George is gearing up to re-take his residency exam, but as he sits down to start, he notices a big drip coming from the ceiling. Somewhere, a pipe has burst, and the pressure is building. Then comes the flood. LITERALLY. The ceiling comes crashing down, and a torrent of gross-looking swampy water crashes down in the middle of an operating room—in the middle of an OPEN PATIENT. Beyond the staff issues, even building is falling apart at Seattle Grace, and the Chief is not happy. At all.
Lexie’s able to diagnose why a patient has had a seven-year headache, but Cristina’s too full of herself to listen to a lowly intern. Lexie goes over Cristina’s head to Mark, (brave, Lexie), who thinks the diagnosis has merit and coordinates some tests with Derek. Lexie’s proven right, but when she opts not to scrub in on the surgery in order to help George repare for his exam, Mark’s disappointed in her for letting her crush get in the way of her career.