Wow... a really dramatic episode this week! The Chief's issues with Bailey finally come to a head. Derek is not dealing well with the loss of another patient and may be leaving the scalpel game. Izzy finally gets a diagnosis for "Patient X" and it's not good. Alex makes a controversial diagnosis that could kill his patient if he's wrong. Oh yeah, and Mer/Der may be off again, but I doubt it.

The Chief spends the day pining for Shepherd, being bitchy to to Bailey for specializinging in pediatrics instead of general surgery, and staring at the surgery board fretting over who will perform the surgeries since he's chased away all of his surgeons.

Shepherd, for his part, has been sitting on Meredith's couch eating all of Alex's cereal and moping about getting sued for killing the pregnant lady who ran over her husband. He finally drags himself into the hospital to talk to the lawyers about the lawsuit and, when Meredith tracks him down to check on him, shows her the stack of charts for patients that he saved and the one for patients that he saved. The stack of people who died in Shepherd's surgeries is significantly larger, which I guess he never really realized. The Chief tries to get him to pick up some surgeries, but Shepherd just tells him that he's not operating and leaves the hospital.

A running background joke is the neurosurgeon who was the acting head of neuro before Shepherd came along. Nobody can quite remember his name, not even me. Instead, he is continuously referred to as "Shadow Shepherd". Sloane has met him several times, but doesn't seem to remember him at all. I suspect he'll be featured more prominently in the next few weeks, though.

Bailey finally gets sick of the Chief being bitchy and decides to call Adele on him, which surprised me since I apparently forgot that she and the Chief were back together. Anyway, Adele drags the Chief and Bailey into the conference room and chews him out for behaving like a child and running his hospital like a playground. She demands that Richard apologize to Bailey and grow up because she doesn't want to have to drag herself down to Seattle Grace again. As she's leaving, she also rips on Bailey for tattling on a man to his wife.

The Chief and Bailey finally sit down to talk and Bailey calls him on the fact that he's been riding her for doing anything that could be perceived as "soft" when the real issue is that he worries that he's getting soft. She points out that all of his worrying and gruffness hasn't helped anything and that he may need to get in touch with his soft side.

Later, the Chief talks to Meredith and asks her to get Shepherd to come back. She insists that sometimes people just want to be left alone, but the Chief tells her about the engagement ring and tells her that the last thing Shepherd really wants is to be left alone.

More on that later.

Yang finds McBadass sleeping on a cot and tries to wake him up, but he freaks out, has a flashback, or something like that, and knocks her into a wall. He feels terrible and spends the day avoiding her until she later corners him and tells him that she's a big girl that gets to decide when she's had enough and it takes alot more to scare her off than a nightmare. He gives her this wounded look and tells her that it's alot more than a nightmare and she just puts her hand on his cheek and tells him that she knows and it's so sweet because neither of them really show emotion or vulnerability and it breaks my heart when they do and awwwwwwwwwww.

Ok, I'm better now.

The trauma of the week is a girl who had a grand mal seizure in the middle of a band competition. When she wakes up, her first reaction is total embarrassment at having a seizure in front of everyone. Once again, Alex has some of his best moments talking to a kid about their problems and showing his understanding while still pointing out the silliness of it all. McBadass assigns him to watch over the girl to make sure she doesn't seize again. Alex complains that babysitting is an intern's job, but McBadass points out that no interns are around since Izzy has them tied up on her "Patient X" project.

While Alex is sitting in her room charting, he notices that she goes into cardiac arrest a second before seizing, indicating that the cardiac arrest is causing the seizure instead of the other way around. At first, McBadass and Arizona the Pediatric Attending think he must be wrong since the girl has no history of cardiac problems and running the tests to see if Alex is right could kill her, but Alex is so certain of what he saw that McBadass decides to back him up. While they're running the test, the girl goes into cardiac arrest again and Alex starts to shock he back, but she then comes out of it, which apparently proves that Alex was right. Though he saved the girl's life, you can see Alex's hands shaking and realize that he was terrified that he made the right call. Nonetheless, McBadass and Arizona are totally impressed with Alex's diagnosis and promise to tell the Chief and everyone else. Arizona even calls him the future of the hospital, which pleases Alex - who claims to never rise to the top of anything - to no end. Ever since Alex and Izzie got back together, he's really been getting his shit together. Izzie's good for him; too bad she's going to die.

Speaking of Izzie, she's still drilling the interns on "Patient X", which is really Izzie. At first, the interns look at the conflicting test results and think that Izzie is trying to trick them and "Patient X" is really fine. Izzie loses it and screams about the hallucinations that "Patient X" has had and insists that she's not fine, and they need to keep looking. Finally, the interns come back with, as far as I understood, a diagnosis of malignant melanoma that has spread to the brain. Note the "spread to the brain" part - my girlfriend predicts that's Shonda Rhimes' out for claiming Izzy doesn't have brain cancer earlier this season. Semantics, but she's probably right. They predict a 5% chance of recovery and suggest that "Patient X" has, at most, five months to live.

Later, Lexie thanks Izzie for the lesson and says she has learned alot Izzie asks her what she would tell Patient X now. Lexie is flummoxed at first but then says "Screw the odds" and goes into a rant about her mom dying of hiccups, which is totally against the odds. In short, I think she's saying she would tell Patient X to keep fighting. Lexie seems somewhat reassured by this and thanks Lexie

George is obviously onto her, which makes sense with all of the research he does, and tells Izzie that he's there if she wants to talk. Lexie isn't ready to talk to someone who cares about her so much, though, but feels like she needs to tell someone, so she decides to tell Yang in that room with the vent. I guess we'll see the outcome of that next week.

Lexie's screw the odds speech seems to have given her hope for her relationship with Sloane, so she finds him and gives him a speech about knowing the odds are against them and that she keeps breaking Sloane, but she still wants to make a go of it. Sloane gets all sweet and tells her that she didn't break him, she's the one who put him back together.

All together now... AWWWWWWWWWWWWWWWW!

Which brings us back to Meredith and Derek. He has apparently taken all of his stuff back to his trailer and is playing beer can baseball, which is where Meredith tracks him down. He tells her to go home, that she wanted him out from the day he moved in and now she has that. Oh yeah, and he's quitting surgery. It's obvious that he's just trying to hurt her to get her to go away because he thinks he's a sinking ship and doesn't want to bring her down with him, and Meredith isn't buying it. Finally, she tells him that the Chief told her about the ring. Derek asks if she wants the ring, then pulls it out and knocks it away with his baseball bat. He then yells at her to go home again, goes into his trailer, and slams the door closed.

For a moment, I thought that Patrick Dempsey may be the cast member that was rumored to want off of Grey's Anatomy so they could pursue a movie career and we were getting faked into thinking it was Katherine Heigl, but I'm back to thinking Dempsey's going nowhere again.

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