Derek is ready to propose. You know, as in pop the question? We’re talking the big “M,” here. This is a huge step, and he’s trying to make it count. He asks for advice and gets everything from Mark telling him to wait—yeah, listen to Mr. Confirmed Bachelor for relationship tips—to Cristina telling him to keep it simple to Richard telling him to go all-out with flowers, violins and fireworks. I guess we know how he managed to keep Adele all of these years, the Chief’s a hopeless romantic. Awww. But when Meredith happens to mention the idea of McBabies—just imagine how incredible their hair would be!—Derek knows the time is right and he starts coming up with a plan.
Now that Izzie realizes that she's sick, she tries testing herself at the clinic, but doesn't get far before her interns arrive. When she has to show Sadie the right way to take blood from a patient, she demonstrates the technique on herself, then tells Sadie to run both tests. Under the guise of training, Izzie has Sadie run more tests on her. Sadie's only discovery: Izzie is anemic.
Cristina is stuck with the very odd Dr. Virginia Dixon again, on a case with a young girl with heart problems. Miranda also gets put on the case, which is hard since she’s had her fill of dying kids, but Arizona Robbins tells her the girl will be fine. But when they’re in surgery, it’s apparent that the girl is going to need a heart transplant and will require a highly regimented series of medications to stay alive until a heart’s available. That would mean that an active young girl would be basically bed-ridden for potentially years, which is crushing news. Then Miranda gets an idea—a backpack with all of the girl’s meds that could be hooked up to her, giving her the precise dosing she needs without confining her to a bed while she waits for a heart. All of the excitement of the idea is a little much for Dr. Dixon, though, and she has a bit of a breakdown, which Cristina and Miranda have to help with by holding her tightly. Who knew hugs were so healthy?
While Derek’s been planning his proposal, he’s been acting a little cagey around Meredith. She takes it wrong and assumes she’s freaked him out with her babies comment. After a lot of discussion with Cristina, Lexie and even a patient, she confronts Derek on his way out of the hospital. He swears he wants to have all of her babies, but he’s got to go, leaving Meredith even more suspicious. What’s McDreamy planning?
Callie is having another bad day. Ever since that fight with Erica in the SGH parking lot, things just haven’t been working out for her, especially in the romance department. To make matters worse, Lexie keeps coming to her to talk about Mark since she’s the only one who knows they’re dating, and giving “Little Grey” dating advice is the last thing she wants to do. So when Callie runs to the bathroom at Joe’s, crying, it’s a shock to see Dr. Arizona Robbins show up to give her some comforting words. But the real shock comes when Arizona tells Callie that there are people waiting for her when she comes out of her funk, and then kisses her right there! Is this finally another love connection for Dr. Torres?
With Mark's help, Derek has decorated his and Meredith’s bedroom with dozens of roses, candles and teddy bears, but just as things are in place, he gets a call, and it’s not a telemarketer. He has to drop everything and hide all of it, saving his proposal for another day. The only evidence of his romantic gesture: A single rose Meredith finds under her pillow.