What an incredibly emotionally heavy episode! Nobody seems to be taking the possibility of Izzie dying very well, especially Alex. Meredith has lured Derek back to surgery, but he's not sure he's ready. Derek asks Meredith to marry him, but she's not sure that he's ready. McBadass's Post-Traumatic Stress Disorder hits a crisis point and he'll have to face up to it. This really could have been a season finale, it was so packed with emotion, conflict, and resolution.

The big surgery that all of the drama revolves around this week is, of course, Derek's surgery to remove Izzie's brain tumor. Through Izzie's Oncologist - a very cold, abrasive woman, think Yang and Bailey mixed together and dialed to 11 - we learn that this is just one of many surgeries and procedures that Izzie will have to go through to get all of the tumors in her body.

Before heading to Seattle Grace, Derek comes by Meredith's house (he has a bag, so he could be moving back in, too) and puts the ring that he had previously knocked into the woods in front of Meredith. Not much of a proposal, and Meredith is worried that he's asking for the wrong reasons, so tells him not yet. Derek looks disappointed, but just goes to take a shower. And that, other than Alex telling him not to screw this surgery up like he did the last one, a conversation with McBadass that we'll talk about later, and minor conversations with other characters, is the last we really see of Derek until the surgery.

The rest of the core group are having alot of trouble dealing with Izzie's illness and avoid her room all day, claiming to be busy, though none of them really do anything. Meredith and Yang bicker over McBadass's PTSD which we, again, will discuss shortly. George begs Torres for some cases to work on, but we only really see him smashing plaster casts to relieve anger.

Alex, Sloane, and Lexie all work on an elderly woman who is about to die. Her niece and nephews, who have all flown in to say goodbye, seem in a rush for it to be over so they can go on with their lives. When Alex finally snaps and goes off on them for being so callous (He's obviously a bit sensitive about death at the moment), they explain that they were told she had hours to live almost a year ago. At least once a month, she goes into the hospital, they're told she's about to go and fly out to say goodbye, and then she recovers. They just want it to be over with. He isn't very convinced and tells Lexie to keep them out after they bring the aunt back to life once again, but the patient tells him that she wants them there. They are her people, and people are better than no people, which seems to slap some sense into Alex and he runs to be with Izzie before her surgery, but she's already in the OR.

When the aunt finally does die, there is a very bittersweet scene where her family finally does cry and mourn and ask if they can stay with her body for awhile longer, so you know - not completely horrible people.

Before that, though, The Chief pulls Alex aside and tells him that Izzie had some of her eggs removed before she started radiation treatments, but the eggs tend to survive freezing better if they're already fertilized. The Chief finally gets to the point that he thinks Alex should fill a cup with sperm so he and Izzie can have a child later. Alex takes the cup, but has some trouble believing that there's any point. Meredith, whose role this week seems to be cheerleading, finally sits him down for a talk and, after totally losing his cool and bawling about Izzie, which actually is pretty cool for him to show he cares, he fills up the cup.

Everyone seems to have snapped out of it about the same as Alex, and almost half the hospital gathers outside the OR to see if Izzie will make it. Before going in, Derek asks Meredith to marry him once again, saying that if she'd just say yes, he could go in there and be okay with whatever happens. Meredith tells him that she can't say yes if it means Derek would be okay with Izzie dying, but she believes in Derek and knows Izzie will be fine. Meredith then goes to wait with everyone else, and Derek scrubs in.

Bailey assist Derek in the OR with the Oncologist overseeing. At first Derek seems a bit unsure, which brings Bailey to reassure him and the oncologist to nitpick and second-guess his every move. You can gradually see him getting his confidence back, though, and when the oncologist questions his use of a certain tool, his explanation to her makes him see that he really does know what he's doing. His confidence restored, he completes the surgery and Izzie is fine - so far.

Bailey comes out to tell everyone that Izzie is okay and admonishes the central group that they sucked as friends today and they need to do better tomorrow.

As soon as he's able, Alex goes to see Izzie. He crawls into bed with her to hold her when she wakes up and you can see tears in his eyes. Somehow, this reminds me of the scene when Denny died and Alex picked Izzie up to carry her when she couldn't walk. I guess it's just the whole "Alex showing how much he cares" thing.

So yeah, Izzie's part down, what about McBadass?

One of the first scenes of the episode is McBadass sitting in bed watching a surgery show. He tells Yang that he can't believe this is how she unwinds and then looks back to see she's sleeping. He covers her up and then lays down next to her, looking up at the ceiling. For some reason, the spinning fan blade reminds him of a helicopter's blades (we hear the helicopter noises) and we fade to black. The next thing we know, Yang is waking up with hands around her throat. McBadass is kneeling above her with his eyes all half-closed choking the crap out of her. Callie hears the commotion and busts in, which apparently wakes Owen up and he falls off the bed in shock. Cristina runs and locks herself in the bathroom and Callie calls Meredith in for support. When Meredith shows up, McBadass is confused and freaking out and Yang has two huge bruises on her throat, but insists she's okay. Yang finally goes out and comforts McBadass about his flashback, which blows Meredith and Callie's minds.

...which is where most of the aforementioned bickering between Yang and Meredith came from - Meredith does not think everything's okay. Yang insists that you wouldn't abandon a man who had a gunshot wound, so why would she abandon him when he has another kind of wound. Meredith and I both agree that the injury isn't his fault, but the fact that he doesn't get help to heal that injury IS his fault. I love you, McBadass, but can the macho bullshit and get some help before you hurt or kill someone.

When Derek and McBadass are receiving patient airlifted in by helicopter, McBadass has a momentary flashback and freezes up, doing that whole eyes half-lidded thing. Derek notices and later tells Hunt that he can help, that PTSD is an injury and it can be healed. McBadass blows him off, talking about guys who came home with real injuries with missing limbs and whatnot. If all he has is some nightmares and occasional freezes, he considers himself lucky. Derek mentions the choking incident (I guess Meredith told him) and says that's more than a freeze. McBadass then gets all indignant and suggests that Derek worry more about his own reputation and recent track record and less about Hunt's

Later, Cristina comes to tell Hunt that Izzie's okay and they start to talk about their relationship. A hug turns into a kiss turns into humping, which I believe is their first time. Afterward, Cristina realizes that she is out of her depth when she's laying in Hunt's arms and is afraid to fall asleep.

Finally realizing he needs to do something about this, Hunt goes to Derek and begins getting CT scans and whatnot. Good for him, though he should have done that a long time ago.

Ok, let's end this on a good note. After realizing that Meredith wasn't saying no because she didn't want to be with him, but rather because she wanted a proposal for the right reasons and the right way, Derek lines an elevator car (because half their relationship is about elevators - cute!) with X-rays from some significant cases in their past. He gives her a speech about each of them, and then ties it up by pointing out when he realized certain things, culminating in when he knew he couldn't live without her and wants to spend the rest of his life with her. It was a great speech and proposal, and Meredith finally says yes.

Happiness - at least until next week.

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