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.
Later, in the elevator, McDreamy and Mere stand on either side of Addison, both fuming. Addie awkwardly asks if there's something going on between them, or if they had a fight. They answer in unison, "NO." Addie wants to make sure that they're all still...friends. "Still"? Mere and McDreamy, poutily: "Yes." They exit the elevator, leaving Addie in there alone with her confusion.
Cristina catches up to Burke elsewhere in the hospital and says she heard he might be getting a heart for a transplant. Burke robotically tells her that Mercy West has a heart, and he's going to get it. Cristina of course wants in. She reminds him that she's done it before, with Bailey. "You can ask her, I was very helpful." Burke cares not: he says he's sure she was helpful, but he's not going to need her on this one. Cristina ponders this rejection on her way to the ambulance bay, where a whole fleet of ambulances have arrived.
The ambulances have brought a surgical bounty of gunshot wound victims, the result of an employee who went postal and shot up a restaurant. George tells the Gang that he heard the shooter got away. Meanwhile, the hospital is filling up with the walking (and not-so-much) wounded. Bailey and Cristina's patients are an engaged couple who both got shot. The girl, Deborah, reveals that her fiancé ducked behind her during the shooting, using her as a human shield. Naturally, she's livid. The fiancé tries to make it all about love: "Deborah! The bullet went through you and into me! That's a sign we should be together forever." I'm pretty sure that's a sign Deborah should kick this guy to the curb forever, but who am I to judge? In response, Deborah shows "Neal" the hole in her arm...that she can see through. Ew. Bailey tells Cristina good luck, and takes herself far away from these people.
Callie and Meredith work on a nice-looking guy with a hipster haircut and a gunshot wound to the leg. Mere tells Callie that the guy got some morphine in the field, and he pipes up, "Ohhhh, trust me, it was not enough." Callie tells Mere to rule out other injuries and get him up to radiology. She's none too sweet about it, by the way.
George wheels in McDreamy's patient on a gurney, a young woman named Kendra Thomas. Kendra's head is all wrapped in bandages, so I'm going to assume that's where she's been shot.
Izzie's patient is Vinnie Van Lowe from Veronica Mars, and he's acting like the few scratches he's got are the most painful lacerations that ever lacerated. He jackassedly asks Izzie, who's cleaning his wounds, if she knows what she's doing, because she's really hurting him. Izzie: "Know what REALLY hurts? Gunshot wounds." Heh. "Brad" says he didn't get shot because he's such a quick thinker (here he calls her "sweetheart," which...shut up, Brad) that when he saw the shooter, he knew what was coming and dove right through the window. Two of Brad's employees roll by, crying into their actual gunshot wounds, and Brad calls out, "Hey Chaz, Larry. No offense, but you guys gotta think quicker on your feet!" Oh my God. Izzie reminds him that the people he just taunted have serious gunshot wounds. Brad can't shut up about how awesome he is. "Really helps that I'm an athlete. When I saw Petey with that gun? I was like, cat quick! Those guys? Not so smart." Izzie takes a wild guess that Petey must have been looking for Brad.
Alex asks Mere if she's seen any enema kits. Mere asks him why he's looking for enema kits when they have thirteen GSWs. Alex: "Trapped upstairs with the Gyno-Beast on the Uterus Parade." Oh, man. That is officially my favorite sentence ever. Mere says Addison can't keep him forever. Alex says she can, too, and swears she's ruined vaginas for him.
Webber reports to Burke that there are two dead and fourteen injured on Petey's little shooting spree, and since he got away, there could be more incoming. Burke offers to stay and send Bailey in his place; Webber tells him no, he's their only cardio-thoracic transplant specialist, so he should go get that heart. Alex overhears this, and his eyes light up as Burke's walking out the door. Cristina tells him to forget it -- she already asked. Alex runs after Burke anyway. Cristina follows him, yelling, "It's not gonna happen!" We'll see. Alex catches up with Burke as he's getting into the helicopter, and asks if he can go too. Cristina yells over the helicopter noise that she asked first. Burke gives Cristina a long look, then says, "Let's go, Karev." Cristina gapes at them as Alex boards the helicopter, all, "See ya, Yang!" Damn, that was cold. Inside the helicopter, Alex asks who the lucky patient is. Burke stares out at Cristina and answers, "Denny Duquette." (Duh.) Cristina stands on the helipad and watches as they take off, first defeated, then angry. She stomps back into the hospital, aaaaand...credits.
Izzie approaches Bailey, who immediately says, "The answer is 'no,' Stevens." Izzie says Bailey doesn't even know what she's going to ask. Bailey most certainly knows that Izzie wants to prep Denny for his transplant. Izzie: "So it's true? He's getting a heart?" Bailey looks at Izzie and says her face right now is the problem; she's overly emotionally attached to her patient. "So the answer is 'no.' Go back to sutures." Izzie argues that she knows Denny's case and meds better than any other intern, and