"Dr. Shepherd!" calls Cristina, stopping him. "Katie competes in beauty pageants!" "I know that," says Shepherd, "but we have to save her life anyway." Baddump bump! Thank you! Goodnight, everybody! Dr. Shecky Shepherd will be here all week! Don't forget to tip your waitresses! Cristina runs through Katie's symptoms and clean scans and then says, "There's no medical proof of an aneurysm, but what if she has an aneurysm anyway?" Shepherd doesn't think she has one. Cristina says she twisted her ankle practicing. "She fell," says Meredith. "When she twisted her ankle, she fell." "It was no big deal, not even a bump on the head," says Cristina. Mere and Cristina seem to think that the fall caused an aneurysm. Shepherd thinks the chances of this happening are one in a million, so he lets the doors close on their enthusiasm. They start to walk away, just as the doors open back up and Shepherd gets off and says, "Let's go." "Where?" asks Cristina. "To find out if Katie's one in a million," he responds. They all run off.
Minutes later, they're all standing over the CT scan tech as he runs the computer through Katie's CT scan. She's off in the distance with her head in a tube. Suddenly, something comes up on the screen and Shepherd says, "I'll be damned." There it is. A nice fuzzy little aneurysm right on the screen. "It's a subarachnoid hemorrhage," he says. Katie's bleeding into her brain. Mere and Cristina were right. They walk off with Shepherd as he tells them that Katie could have gone her entire life without anything happening to the aneurysm. However, one tap in the right spot and the thing exploded. He tells them that they did great work and that he'd love to stay and kiss their asses, but he has to go tell Katie's parents that she's having surgery. Cristina reminds Shepherd that he said he'd pick someone to scrub in on the surgery, and he says that of course he remembers. Then he picks Meredith to scrub in, and Cristina shoots her a look with a big fat scarlet letter attached to it.
We check in with George, who's waiting outside the OR where the heart patient is going through his routine procedure. George drinks a juicebox, hovers in the hall, checks the patient again, then turns his back on the entire procedure and generally tries to avoid bringing his bad juju into the OR. Unfortunately, George's juju travels through walls because the heart patient doesn't make it through his routine procedure, and he dies on the table. Even though George promised his wife that everything would be just fine. Burke exits the OR and tells George that the heart was too damaged to survive the bypass. "But...I told his wife...I told Gloria that he would be fine," stutters George. "I promised her that--" "You what?" snaps Burke. "Why are you promising anything? This is my case. Did you hear me promise? The only one who can keep a promise like that is God, and I haven't seen him around here holding a scalpel lately." That's because God is in the bathtub, Burke. "You never promise a patient's family a good outcome!" he says. "You're important enough to make promises to [Mrs. Heart Patient]? You get to be the one to tell her she's a widow."