During Waverly's operation, Addison asks Alex about the Jane Doe/husband reunion. He completely brushes it off and overacts that he doesn't care. "Whatever, he cried like a baby, she looked bored." Addison's surprised at him, but Alex just says that it's complicated since Rebecca doesn't know if she wants to be with him. Pouty Izzie pipes up, "It's not, actually, complicated. They're married, she took a vow. You don't mess with vows. Married is married. Game over. So frickin' over." OH MY GOD SHUT UP. I miss old sassy Izzie who was more than one dimension of stupid and bitter. This Izzie is boring and aggravating, and I'm going to hurt my hand trying to reach into the TV to smack her. The Bad News Beeps begin; Waverly's flat-lining, and Addison hurries to get both babies out so that Burke can start working on her.
George and McDreamy are working on Axehead. They have quite different opinions about him -- George is sympathetic, and believes that he's allowed to turn back if he's scared, but Derek thinks he didn't have a right to do that. "You chose to climb a mountain, you can't change your mind in the middle of a climb." This metaphor is kind of like an ice axe in my own skull right now, it's so subtle. There's a lot of close-up shots of the axe in the guy's brain, which I can't stomach at all. Dear Special Effects Man: You're very good. I get it. Please accept my compliments, after I vomit. Well done. They're now ready to pull the axe out, and Derek says that there will be some tearing around the wound since it happened while they were falling. It's a lot less easy to dislodge than he expected, and once he gets it out, the wound is perfectly clean. George says he's a lucky guy, but Derek thinks maybe the axe didn't actually lodge in his skull by accident.
It's Burke's turn to have his Chief of Surgery hopes dashed. Richard explains, "It's probably unfair, but I hold you to a higher standard. And you let me down this year, Preston, after you got shot, the tremor." Finally! Sweet comeuppance for operating for weeks with a tremor and making his intern girlfriend handle his surgeries! The karma is a sweet little nugget in this super-sized episode of aggravation, one that I'm going to savor. Richard: "This job is about making the tough calls. Sometimes the toughest call you can make is admitting you're in over your head. You don't do that." This speech could almost be used for other areas of his life, but I can't quite figure out exactly what just now; it's a bit too obscure for me. I'll see if I can figure it out by the end of the episode. He tells Burke he wants to give him the job, but he can't. Burke is serene, and without speaking he gets up to leave. When Richard calls his name, he just turns and smiles, saying he has a wedding to get to.