Hour Forty. Shepherd's shaving Katie's head and telling Mere that he promised he'd make her look cool. "Did you choose me for the surgery because I slept with you?" asks Mere. "Yes," says Shepherd. Hee. "I'm kidding." Double hee. Mere wants out of the surgery. "You're Katie's doctor," says Shepherd. "And on your first day, with very little training, you helped save her life. You earned the right to follow her case through to the finish. You shouldn't let the fact that we had sex get in the way of you taking your shot." Meredith seems to consider this.
Later, outside the hospital, George and Meredith, 007 and the boss-fucker respectively, sit on a windowsill and discuss how they wish they wanted to be ski instructors or postal workers instead of doctors. George's parents tell everyone he's a surgeon like he's a superhero or something, and Meredith's mother tried to talk her out of being a doctor, saying she didn't have what it took to make it. "We're gonna survive this, right?" he asks. Meredith doesn't answer him.
Back inside, Meredith watches as the Chief starts grilling Karev about his ancient pneumonia patient. Karev doesn't have any answers. The Chief asks Karev to name the common causes of post-op fever. He can't. The Chief asks the room, and the only person who has the answer is Meredith. "Wind, water, wound, walking, wonder drugs," she says. She goes on to say that it's usually wind or pneumonia, and that pneumonia is easy to assume, especially if you're too busy to do the tests. The Chief shoots Karev a look, and then he asks Meredith what she thinks is wrong with the patient. "The fourth 'W'," she responds. "Walking. I think she's a prime candidate for a pulmonary embolus." The Chief asks for her diagnosis, and she rattles off a lot of words I don't understand. The Chief does, though, and he tells Alex to do exactly as Mere said and then tell his resident that the Chief wants him off this case. Heh. "I'd know you anywhere," says the Chief as he passes Meredith. "You're the spitting image of your mother. Welcome to the game." Nice.
Meredith enters Katie's OR, and Shepherd says that it's a beautiful night to save lives so let's get in there and have some fun! Meredith's voice-over says that she can't think of any one reason why she'd want to be a surgeon, but she can think of a thousand reasons why she should quit. We get a bit of a music/voice-over montage of all the interns as Meredith continues, saying that they make it hard on purpose because there are lives in their hands. "There comes a moment when it's more than just a game," says the voice-over. "And you either take a step forward or turn around and walk away." Shepherd beckons her over, and she takes that step forward and moves to the microscope to work on Katie's aneurysm. "I could quit, but here's the thing," her voice-over continues, "I love the playing field."