Our favorite brilliant neurosurgeon, Dr. Derek Shepherd, is hiding in the woods. He’s smack in the middle a crisis of confidence because of the many patients he’s lost. The big blow-up with Meredith also weighs heavy on his mind. The Chief is at a loss, so Bailey takes it upon herself to send Callie, then Owen, out to talk some sense into Derek. But misery loves company. Now three of Seattle Grace’s top docs drinking their pain away in the great outdoors!
Mark throws himself into his work after his fistfight with Derek. He preps for a rare and prestigious face transplant surgery. The patient is a sweet, young guy named Dave, who happens to be missing half of his face. This leads some of the Seattle Grace team to nickname him “Blowhole.” Izzie take exception to the moniker. She snaps in front of the patient, forcing Mark to kick her off of the case.
Lexie is tired of all the interns’ speculation about her relationship with Mark. So, she lays kiss on McSteamy right in front of them. She says to Sloan, “They think you’re taking advantage of me. They think I’m using you. But they don’t know us."
Cristina finally gets that solo surgery that she totally deserves, but she can’t concentrate because she’s carrying the weight of Izzie’s secret cancer. She spends her pre-surgery time bending over backwards getting Izzie an appointment with the best oncologist at the hospital. Izzie blows off the appointment. After seeing how everyone’s been treating “blowhole,” Izzie’s not sure she can handle being a patient at Seattle Grace. Izzie tells Cristina to forget about her cancer. Yeah, like that’s going to happen.
Fed up with losing his doctors to Mother Nature, not mention lots and lots of liquor, the Chief himself heads out to Derek’s trailer. Derek lays into the Chief for sending Meredith out there looking for a ring. He blames Richard for destroying him, but the Chief refuses to accept that. Richard tells Derek that he knows all about guilt, all about how hard it is to forgive oneself. He sent Meredith out to bring Derek back to life and if he ruins his chances with her, that’s his own fault. It’s not enough to convince Derek to come back, but he does call Meredith.
It’s time for Cristina’s solo surgery, with Bailey observing and Alex assisting. Cristina has trouble concentrating at first and, before she even picks up the scalpel, she calmly let’s Izzie’s secret out. She has cancer and it’s bad. Alex and Bailey are shaken, but Cristina’s head is finally clear. She performs her first solo surgery flawlessly.
After the surgery, Cristina tells Izzie that Alex and Bailey know about her illness and that they are telling Meredith and George. Cristina says, “I think you came to me for help, and that’s what I did. Sometimes we win, Izzie. And I want you to fight.” We do, too.
Meredith goes to the trailer after Derek calls her. "I love you," he says before asking her "Would you still love me if I weren't a surgeon?" She says, "No," and tells him Izzie has skin cancer that's spread to her brain. Derek is "one of about 20 people in the world who can save her. And I don't know if I could respect somebody who could walk away from a gift like that. So please don't." She shows him Izzie's scans. "It's pretty bad," she says before driving away.
Izzie’s friends are there to help her into her hospital gown as she makes the leap from doctor to patient. It’s a scary time for her. But, as we already said, her friends are there to help.