Archer’s brain tenants have multiplied! Addison prays! McBadass tends to lose touch with family and friends, just like me! It’s revealed that pretty much nobody likes Archer, which makes me feel less guilty. Annnnnnnd an intern finally gets to scrub in on a surgery.

Addison, Archer, and Naomi arrive via ambulance at Seattle Grace. While Derek is trying to find a way to operate, word spreads throughout the hospital that Addison’s in town, to the delight of most.

Derek discovers that the initial single cyst in Archer’s brain has multiplied into eight, meaning the worms are spawning. Derek doesn’t think he can maneuver the probe without breaking one of the cysts, and decides he can’t operate. Addison gives him a speech about needing him to be a god and save her brother and goes off to pray, something she apparently never does.

Derek keeps looking at the CT scans and still sees no way to pull the operation off until Sam shows up and suggests that Derek just remove each cyst as he goes. Archer begins to refuse until Derek calls him a coward and goes into a rant about how all neurologists are cowards, preaching drugs and non-surgery until there’s no choice and then passing the patient on to a neurosurgeon so they won’t have to take responsibility. Derek says he’s ready to take responsibility and questions if Archer is as well. It’s a very harsh speech, but Archer’s an ass so nobody cares and it apparently does the job because Archer agrees to the surgery.

Incidentally, I love that absolutely nobody likes Archer other than Naomi and Addison. And Addison kinda has to like him, since she’s his sister.

Anyway, Derek goes in with the scope and removes the first seven cysts (along with their squirmy brainworm contents) fairly easily, but the eighth one bursts and the worm escapes down the ventricle. This causes Archer to go into cardiac arrest and everyone to get ready to revive him, but Derek waves them off so he can get the worm within the three-minute safe zone. He catches it in something like two minutes and forty-five seconds.

Archer lives to enrich everyone’s lives with his douchitude. Yay?

As previously mentioned, Sam has flown down to offer moral support for his friends (apparently he’s known Archer since college, too) and spends most of the day having asthma attacks and fascinating Bailey. At first I think Bailey may have a crush on him, but over time it becomes clear that she sees him as someone who let go of his marriage and has to live with the results of that choice every day. After Archer comes out of surgery and everyone (especially Naomi) is fawning over him, Sam has a major attack and has to be admitted into the hospital.

We see the woman that McBadass ran from last week in a hospital room with her father. She’s fussing around him while the doctors discuss a renal blockage or something along those lines. The father finally tells her that he’ll be fine and she should go to work. As soon as she leaves, he reveals that he has advanced colon cancer and he doesn’t want his daughter to know because she’ll freak out. Just then McBadass walks in and tells the man that he really should tell her daughter. He’s sparing her pain now, but it will cause even more pain later when his death takes her by surprise. The man yells at Owen that he has no right to tell him what he should do when he broke off their engagement in a two-line e-mail. Not cool, McBadass!

Later, while he’s trying to explain to Cristina what’s up, the ex-fiance shows up and is so happy to see that he’s back that she throws her arms around him. He calmly takes her arms off of him and walks away without saying a word.

Even later, after the father’s surgery, Owen comes to tell her how it went. She doesn’t seem to be listening, though, and keeps telling him how different he is. Finally, he just tells her about the cancer and that nobody wanted to tell her because she’s so damn sheltered and can’t handle bad news.

Owen finally corners Cristina and explains that he doesn’t want to see anyone from his past because he can’t bear to see the look in their eyes when they realize the man they knew before the war is gone. He tells Cristina that the first time he’s felt real in a long time was when he’s with her because she sees him for who he is.

Izzie has decided that the interns need something to make them excited about medicine again and creates a contest to test their medical knowledge and skills with a prize for the winner.

Sadie doesn’t do well at all and George, who’s helping Izzie run the contest, begins to realize that she doesn’t really know how to do any of the things that interns are expected to know. He tells Sadie that if she doesn’t go to the Chief, he will because she’s going to end up hurting someone. Rather than admit to cheating, Sadie decides to just quit the program. Another blonde lesbian rides off into the sunset.

I’m starting a petition to save Arizona, y’all. Blonde lesbians are an endangered species on Grey’s Anatomy!

As the contest nears its conclusion, Izzie realizes that she has no prize and begs the Chief for help. Lexie wins the contest and the Chief blurts out that her prize is scrubbing in and running the suction machine on Derek’s next surgery.

The pregnant woman who ran over her husband last episode was pushed out of her surgery slot for Archer. Derek comes in to promise her that she’s up first thing in the morning, but she begs him to operate tonight. She’s very convincing and he agrees to do her surgery tonight.

Derek somewhat mocks Lexie’s excitement, which distracts him just enough to nick an artery in the woman’s brain. There’s a moment of panic, but he’s able to repair the damage fairly easily and the rest of the surgery goes well.

Later, Derek is celebrating with the San Francisco crew and Sloane at the bar when he’s paged away. He tells everyone that it’s nothing, but they’re disturbed by his rushing manner and run to the hospital to check on Archer.

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