Momma sits up, slapping at Alex's hands, demanding to know what he thinks he's doing. Alex says he's just trying to examine her. "I don't THINK so!" Momma tells him, then whispers, "I don't have any panties on and I do not know you well enough to let you see my Good Girl." Good Girl? Va-jay-jay? Not that I should be one to make fun of euphemisms or anything. After Momma insists he get her a "lady doctor," Alex shouts, "I need a chick over here!"
Meredith tells McDreamy that John Cho is named Marshall and he's a surgical intern over at Mercy West. McDreamy checks Marshall out and tells him to remember three words that Meredith will ask him for later. McDreamy gives Meredith final instructions and says, "Not now," when Meredith tries to ask what wife crawled up his butt and died. Meredith turns her attention to Marshall, who can't remember the words McDreamy told him, nor can he figure out what happened.
That stream of gin from the opening doesn't remind me so much of "kicking back with a few martinis to slough off the day's giant tumor" as it does "extraordinarily hydrated man peeing from a very great height." I think it's the arc.