Izzie returns to work, Cristina is still covering for Burke and Meredith catches a beautiful mystery woman sprawled out on McDreamy’s bed.
Meredith is upset because Derek hasn’t called even after she told him she broke up with Finn. She goes to his trailer to find him fresh out of the shower, as a beautiful woman sits on his bed. She should have called first.
Cristina takes over writing the surgery schedule to protect Burke. She’s so busy that she doesn’t have time to listen to Meredith’s complaints about Derek. So, George says he’ll be Cristina for Meredith if Meredith channels her inner-Izzie for him. It’s a pretty hilarious exchange, especially when George sums up the Derek situation by saying, “So McDreamy was doing the McNasty with a McHottie? The McBastard!” What a McRiot!
Izzie is cleared to return to work at Seattle Grace. The Chief assigns her to Bailey. He tells Bailey that some staff members have concerns about her judgment. She needs to prove herself via Izzie. Bailey tells Izzie to shadow Meredith. She is to “observe only.” Yeah, we’ll see if that happens.
Meredith finds out the woman from Derek’s trailer is actually his sister, Nancy. Nancy suggests that Derek take some time for himself. He takes his sister’s advice to heart when he runs into Meredith. Derek says he wants things to work between them but he needs to take some time to clear his head. We’ll see if that happens, too.
Noelle, a woman who was born with two uteruses, is expecting twins, a baby boy in one uterus and a baby girl in the other. Addison discovers the babies have different due dates, six weeks apart. Noelle’s fiancé, Greg, realizes he can’t possibly be the dad to the baby girl. Noelle slept with another man during a stretch of time they’d broken up. Greg is crushed. He walks out leaving a scared and remorseful Noelle alone. When Noelle tries to go after Greg, she collapses, jeopardizing the baby boy, who is due soonest. Addison and George rush Noelle to the OR for an emergency C-Section. Alex, tired of being Sloan’s errand boy, scrubs in as well.
As Addison works to deliver the boy, George has to keep the other baby from tearing the uterine wall. When the baby girl starts moving, Alex tries to settle her down by talking sports, just like Greg does. It works. The baby calms and the rest of the OR enjoys a recap of 1974’s “Rumble in the Jungle” between Foreman and Ali. They cut away before Alex finished his sports report. Ali won. We looked it up.
Noelle wakes to find that both babies are fine. She asks for Greg, but Addison tells her he’s gone. Groggy and confused from the anesthesia, she asks about Greg two more times. Third time’s the charm, as Greg steps into the room. He tells Noelle that he saw their son and he’s amazing. He then puts his hand on her belly and asks, “But how’s our little girl?’ Chills. That’s all we have to say. Everyone here got body-shaking chills! Except for those of us who were brought to tears.
George tries to make up with Callie by relaying a metaphor about a chicken and a pig he learns from Greg. Sorry, you just have to watch the episode to get the full story. It’s way too hard to explain. Callie is initially confused, but once she realizes that George isn’t calling her a pig, she softens. And judging by the way she blows off McSteamy, she may even be willing to forgive our boy George. McSteamy isn’t ready to forgive Alex though. He tells him that by scrubbing in on that C-Section, he gave up his chance to work in plastics.
Izzie believes a woman preparing to retake the bar exam burned her hand on purpose to avoid the test. Meredith thinks Izzie is projecting her own fear of failure. Against orders, Izzie asks the woman if she burned her hand on purpose. We told you she couldn’t just “observe. Izzie was right. Ther woman did hurt herself, so they take her up to the psych ward but she balks, insisting she's not crazy. Izzie tells her, "We all need help sometimes."
A man with a cardiac tumor needs what's called a "Humpty Dumpty" surgery, which is very complicated. It involves taking the heart out, scraping out the tumor and then putting it back in. Without having told Burke, Cristina schedules the surgery. She convinces him they can pull it off.
Miranda sees the surgery up on the board and puts her name down to scrub in before Cristina can stop her. When no one is looking, Cristina erases it. Miranda sees her name has been erased but doesn't say anything until after the surgery when she confronts the clueless Burke. He sees Cristina's stricken face and lies that he couldn't use Miranda. But when Miranda spots Cristina writing on the board later, she knows something is up.