Well. To echo the constant refrain of the episode thread: HOLY SHIT. So Burke gets a call that there's a heart available for Denny across town at Mercy West. Cristina begs to go along with him for the ride, but he's still mad at her for falling asleep during sex and takes Alex out of spite. When they arrive, they're informed that there are two hearts available -- the dead guys are a pair of brothers who crossed the center line and ran headlong into a semi -- and the doctor getting the second heart is Burke's old med school rival. Alas! Burke's guy is already dead, so he runs into the other OR to try and steal the one good heart for Denny. Turns out the intended recipient of the good heart made the transplant list just seventeen seconds before Denny did, so other guy is technically the winner -- unless Denny's condition deteriorates dramatically within the next hour or so, that is.
And what do you imagine happens when Izzie finds out about this? Why, she comes up with a diabolically CRAZY plan to stop Denny's heart by cutting his LVAD line. It'll be okay, she says, because Burke is on his way back to the hospital any second to revive him! That way Denny can live, get the heart, and everyone will live happily ever after. And since it can never be said enough, Izzie Stevens COMPLETELY drops her basket, going so far as to drag George and Alex along for her insane little ride.
Meanwhile, a bunch of gunshot wounds arrive at the hospital, the result of a disgruntled ex-waiter attempting to shoot his overbearing manager (who didn't even get shot, just lacerated!). One of the more heartbreaking victims is a young pregnant girl who was shot in the head. She ends up brain dead, leaving her parents to decide whether to keep her alive long enough to deliver her baby.
In character relationship news, Mere, McDreamy, and Addison get the news from McVet that Doc has osteosarcoma. McDreamy is still stupidly upset with Mere for dating Finn, and he shows his ass in front of all of them. Poor Addison finally realizes what's going on -- after a particularly painful conversation with Meredith, in which she pathetically asks her husband's dirty ex-mistress if they're still sleeping together -- and confronts McDreamy. Unfortunately, she does it in front of the entire hospital. Callie is a total bitch to Meredith in re: Doc's illness, but redeems herself slightly after a little talking-to from George. Callie sadly unredeems herself by telling George she loves him -- and George, bastard that he is, leaves her hanging to go help Izzie with her "plan."
Speaking of which. Just as Izzie is getting ready to cut Denny's LVAD cord (in front of a totally stricken George), the original-target restaurant manager is released from the hospital. What nobody could have imagined is that his shooter is waiting for him outside. Shots are fired. Bailey hears them from inside the hospital and runs outside. The manager is down. And, as much as it pains me to say this, my friends, so is Burke. BURKE! Dr. Burke is on the ground and he has been shot, is what I am saying to you. Izzie doesn't know this, though, and cuts through Denny's LVAD line with a pair of scissors, saying, "It's okay, Dr. Burke will be here in a minute." Holy shit!
Welcome to the first third of the season finale! We open at Joe's bar. Mere voice-overs that, in life, we're taught that there are seven deadly sins. "We all know the big ones -- gluttony, pride, lust." Burke and McDreamy are sitting at their own table, away from those icky girls. The icky girls sit at another table nearby and watch the men (hotly) play some darts. Burke flings his dart at the board so hard that it makes a "thwack!" sound as it hits the bull's-eye. I'm going to take this dart-playing scene as a psychic shout-out, as darts are mine and my husband's current obsession and bar game of choice. Cristina turns around to watch and comments, "He's picturing my face. He's totally picturing that dart puncturing my skull." Mere VOs that the thing you don't hear much about is anger, maybe because we think anger's not that dangerous. As she says this, McDreamy takes his turn at the board, and hurls the dart with beautiful manly force. Izzie says he's so picturing Meredith right now. Mere: "He called me a whore; he lost the right to picture me." Cristina's all, "So I fall asleep during sex, so what?" The boys glare at the girls, and the girls glare back, each proclaiming, "ASS!" Alex strolls by, and Izzie calls out, "Oh, aaaaass!" She throws back a shot. Hee. Alex snaps back, "Isobel Stevens has finally left the hospital -- does this mean heart patient Denny finally kicked it?" Izzie says she's sorry, but this section of the bar is for surgeons only; they don't socialize with gynecologists. Damn, I like drunk Izzie. George walks over with Callie and sits down. All the girls greet George heartily, and then are all Mean-Girly, "Ohheycallie." Poor Callie. Mere voice-overs that we don't give anger enough credit -- maybe it can be a lot more dangerous than we think. "After all, when it comes to destructive behaviors, it did make the top seven." We get one more shot of Incredibly Angry McDreamy, then cut to...
McVet's office. His initial diagnosis of Doc is bone cancer. Aw, Doc! Mere and McDreamy have a snitty little session of "Bone cancer?" "Are you sure?" "That's what he said, isn't it?" "I HEARD HIM." This makes Addison and McVet uncomfortable, as it should. McVet tells them that osteosarcomas are aggressive, but they can try to treat it with chemo, or remove the tumor entirely, but he needs to first see how far it's spread. As a last option, they can amputate the leg. McDreamy asks if it's even worth it at that point. Mere: "Oh, right. Let's just let him die!" McDreamy, clearly projecting, says he doesn't want "him" to suffer.