Sadie rips a cuff off of Rob's arm as Izzie and Alex watch, and I'm stunned that she seemed to actually get something right as she announces his blood pressure. He asks the residents what the prize is for winning, and Jen adds that they need a prize. Izzie assures them there is a big prize, then leans over and tells Alex they need a prize. Ah, writing cliché #143 this hour. Mere comes in and asks what's going on as Sadie starts an ultrasound on Jen, and Alex explains that Jen and Rob needed a distraction, and Izzie needed real patients for the contest. Izzie is still a little bit over-excited about how much fun this all is. Jen asks when her surgery will be and Mere assures her it could be any time now. But first, Jen's in for a horrible shock when Sadie puts on her "bad news" face and says that she can't find a heartbeat. Alex is there in a flash to announce she's on the baby's butt, and finds the beating heart much to Jen's relief. Izzie claps maniacally at Sadie to try and lift her spirits, which just makes Sadie madder and Izzie look all the more insane. I do like the nod towards Alex and his good touch with moms and babies, which has basically been forgotten since Addison left and the writers got tired of that storyline.
Hunt finds Cristina supervising Bernard's scan and announces (as if the technician isn't even there), "It's not what you think." Those technicians, nurses, and other random employees must go home every night and just tell their friends the most amazing overheard gossip. Hunt also tells her that he's not as much of an ass as she thinks she is. She ponders this and then asks him if his mother knows he's back. His silence answers that question nicely, so she turns and asks the technician to page her when he's done and then leaves.
Derek is back in Archer's room, explaining the method he came up with (courtesy of Sam) for removing the cysts. He needs to create room to maneuver, which he'll do by deflating the cysts one at a time. I don't really understand it, but all that's required of us viewers is to smile and nod and know that Derek is putting on his God hat. Archer throws back that the cysts will rupture, so Derek counters that he'll be able to suction the fluid. Archer says he'll have to be precise, and Derek says he will be. There's clearly no love lost between these two, and I suspect that Archer is covering up his fear by being an asshole. Addison explains for the laypeople that Derek will control the way the cysts rupture, but Archer thinks he can't do it and starts to tell everyone that while he's supposed to fight, he's totally not doing it. Derek cuts him off before he can say all that and taunts him, calling him a coward and saying that as a neurologist he's a "coward by trade," who pawns patients and responsibility off on the surgeons. Derek's trademark confidence is back, and he boasts, "I can assume the responsibility. The question is, can you?" Archer glares at him, and there's a lot of manly tension in the room. Inexplicably, Mark seems to be in the room for this conversation. Maybe to up the hotness factor, which is already nearly off the charts with Sam there as well?