Cristina finds Teddy and tells her about Ruthie now wanting a pig valve instead of a mechanical valve; she seems pretty freaked out at having prepared for hours for the mechanical surgery when now she's going to have to do something else. Teddy just tells her she's learning a lot and asks if she should find someone else if Cristina isn't comfortable. Cristina, never one to back down, assures Teddy that she's fine and runs off.
Derek walks in to find Tom and give him the good news: he's only got a concussion and they don't need to go in and fix anything. Well, anything in his head, at least -- he does need his spleen removed but that's a simple procedure that will only keep him out for the end of the season, and he'll be back playing in no time. Alex is there too and smiles encouragingly, but Tom starts to hyperventilate and the docs immediately get him an oxygen mask as he grasps at his chest.
It turns out that Tom was having a massive panic attack, and Derek asks him if he's ever had one before. Tom insists he's fine and when his wife comes in with his son, he cuts off Derek so that he doesn't tell her about what just happened. He tells her that he can't play until next season but she assures him that the next season will be here in no time. Derek watches with his patented solemn/thoughtful/worried/mildly judgmental face.
After witnessing Reed's show Mere isn't clutching her own pearls, but she is kind of appalled at her friend and goes to ask him if he's trading surgery for sex. Alex doesn't really answer the question and just says he'll sleep with Reed if he wants to before pointing out that Mere probably got a few extra surgeries from Derek after some time in the on-call room. Meredith reminds Alex that even if it doesn't feel like it, he's still married, but he's not having any of it and cuts her right off, telling her that he's done worrying about Izzie as she clearly has done the same. She says that this is the old Alex, and reminds him that they both grew up and got married. Alex retorts, "Yeah, well it turns out your stupid post-it is ten times the marriage my church wedding ever got me. I'm moving on." While I pray that's true since these episodes without Izzie have been glorious, I have a sneaking suspicion he's going to have to face her and his broken marriage sooner rather than later.
Bailey is stunned when Derek tells her about Tom's panic attacks, and Derek muses that he doesn't know why Tom isn't talking about them. I don't know, Derek, could it be because he's a big-time, famous, supposedly-tough football player who might not want to show weakness? I don't know, that's a tough one to guess at. He then tells her about Sheldon's follow up, and begins to fire questions at her about the level of care he is receiving and if there was a mistake made by the Chief during the surgery. She can't get him to stop so she pulls out the big guns, telling Derek she has a thing for Sheldon and that's why he's been in so often. It's so farfetched that Derek's anger subsides enough for him to look amused as he holds up the yellow photo. Bailey tries unconvincingly to say that she is drawn to Sheldon but can't put her finger on why that is, and Derek smirks because he knows "humpin' and pumpin' is not Sheldon's strong suit." When he offers it to her, she snatches the picture from him before stalking away.