Cristina is looking at Ivan's test results and clearly the tube hasn't worked, since she tells the nurse to book an OR. He begs her for more time and when she doesn't give it to him (on account of his perforated bowl) he asks if she can at least salvage the worms. She's mystified by all this and tells him his life is at risk because of research that's clearly not working out because otherwise he'd have backing from some accredited institute. She tells him, straightforward, to let the worms go, but he grabs her arm and tells her he worked at those institutes and was dead inside, but realized what he was meant to do with is life is this research. He goes on to say that everything else -- his quirks, people finding him strange -- doesn't matter because he knows who he is. He begs her to save the worms and she's clearly a bit affected, what with all of her own soul-searching, not-knowing-herself problems of late, but after a second she brushes off his hand and gets back to the business of prepping him for surgery.
Lila is reading the release form that lists all of the horrible things that could go wrong during her surgery, and when she goes to grab the pen her hand starts to spasm and she can't grasp anything. Mere is very serious and asks when that started, and when Lila tries to brush it off Mere stays on her. Lila admits it's been a few months and Mere tries to convince her that the doctors can help, but Lila tells her she already knows how it will go from having seen her mom through it. And it sounds hellacious -- slurred speech, followed by trouble walking, difficulty eating, seizures, memory loss, and dementia. She's trying to keep her cool but is starting to cry as she says screw going to the doctor, she's going to Brazil.
Meredith goes in to see Richard, who is obsessed with marketing the hospital and asks if Derek would consider his face on a billboard. Thankfully, Meredith is aghast at the cheesy shot of him with the tagline, "Where doctors are your friends." They really should add, "Where doctors drive recklessly." "Where the doctors carry on personal conversations in front of patients." "Where doctors will make you feel uncomfortable while we bicker in the open." She finally gets his mind off of the billboard when she asks him if he thinks Ellis ever tried to tell him about the Alzheimer's, back when she was still working at the hospital. He immediately says no, but Meredith presses that maybe she tried to tell him but he didn't realize it? He finally admits that he supposes that is possible, and asks her if everything is okay, since this is all rather pointed and out of the blue. But Meredith says it's fine, and she actually sounds sincere about it even though she's obviously got a lot on her mind. Before she leaves she does admit she'd never go to a hospital that put pictures of their doctors on billboards.