Ruthie, meanwhile, is having a crisis because she watched her sister eat a pork chop and didn't feel any kinship with the pig, so she wonders if she should cancel the porcine valve after all. I personally think it's a good thing to not feel kinship with the animal flesh on your plate, but for Ruthie, it's a problem. Cristina asks if Ruthie might feel kinship with cows while a very amused Teddy watches this all unfold. Cristina tries to tell Ruthie that a bovine valve surgery is totally different from both the porcine and the mechanical valve surgeries but Ruthie isn't worried about Cristina's feelings and instead asks if she could see the valves. Cristina tells her that it's impossible but this makes Ruthie want to call it all off, so Cristina changes her mind and offers to bring her valves so that she can bond with one. Ruthie is thrilled and after Cristina leaves, can't stop telling Teddy how wonderful Cristina is.

Joking time is over for Derek, and he finds the Chief and asks if he wants to do Tom's spleenectomy. Richard tries to brush it off and have Bailey perform it, but Derek is tenacious and gets Richard to agree by pointing out that he might make an exception to his surgical vacation for such a high-profile client. Richard agrees halfheartedly to do it, but as he goes Derek stares him down with a Death Ray of Judgment.

While Cristina begs a technician to bend the rules and bring her a couple of valves, Mere tries to make a phone call. Cristina gripes that prepping for three different surgeries might kill her and Meredith counters that it's a gut decision Ruthie has to make: pig or cow? Cristina totally disagrees and says it's an educated decision. Golly, I wonder if Cristina will be faced with making a gut decision later? Mere doesn't answer because Izzie's voicemail picks up, and she leaves a message warning her that Alex might be moving on. Cristina takes a different approach, and yells into the phone that she needs to come work in the clinic because she's throwing her career away. Meredith admonishes her (as do I, because seriously the quality of the show is exponentially higher without having to shoehorn in Izzie's sneering face and shitty storylines) but Cristina explains that she was fired from surgery, not all medicine. My favorite thing is that they had that exchange while Mere was still leaving a message, so Izzie will get to hear all of that when she retrieves her voicemail. Mere hangs up as the tech brings a delighted Cristina two containers that hold a pig and a cow valve, respectively.