Previously on Grey's Anatomy, if Derek signs the divorce papers, Addie will leave. She won't leave if she thinks there's the tiniest of chances he might want her back. Alex failed his boards and if he fails them again, he won't be a surgeon. He then won't let Izzie kiss him. Cristina and Burke fought, then he held her in the hospital. It's all been very dramatic.
There's a shot of some amazing lightning over the Seattle skyline to back Meredith's opening VO: "Pain comes in all forms." Izzie gets home from her date with Alex, the one that started with no kiss. She gives him some crap about how it was the "best date ever," until he can break in and say he had a good time. But then he dodges another kiss, nicely bookending Izzie's evening. VO: "The small twinge, a bit of soreness, the random pain. The normal pains we live with every day." She exclaims, "Seriously?! Seriously!" before slamming the door in his deserving face, and stomps up to George's room where she wakes him up so he can scooch over and she can get into bed and bitch over his protests that he wants to sleep.
"Then there's the kind of pain you can't ignore. A level of pain so great that it blocks out everything else. Makes the rest of the world fade away." The pain Meredith can't ignore is the sheaf of unsigned divorce papers that her boyfriend has been toting around. VO: "Until all we can think about is how much we hurt." She's yelling at him and he tries to interrupt her, saying her name. She calls his bluff and asks what, but he's stumped. "I usually just say 'Meredith' and then you yell at me." This earns him a deserved beating by handbag until she can also get inside and slam the door with her own, "Seriously?!" She then joins Izzie and George, who remarks on the small size of the bed once two enraged females are in it with him.
Mere wonders how a brain surgeon can be so brainless. Izzie exclaims that she shaved her legs for this date. George shushes them and pats each of their legs. VO: "Pain. We anesthetize, ride it out, embrace it, ignore it." Cut to daytime and Cristina running into the hospital through a downpour. "And for some of us, the best way to manage pain is to just push through it." Now Meredith is just echoing my father's advice when I got hurt playing basketball in high school and wanted to take a week off.