This week was really an exercise in balancing the depressing with the absurd, so let's get the depressing out of the way first. Derek starts his clinical trial and as promised, he doesn't let Meredith assist since he thinks it will make things too personal. Even though she knew this would be the case, she's miffed, all the more so when she finds out Alex won the job instead. The boys quickly realize, however, that this isn't just a matter of compiling data for research; Alzheimer's tends to rip families apart, and they're going to have a hard time not getting emotional during this study. Case in point: Rose from Lost is the wife of one of the patients who, when he's lucid, loves her dearly as he has for 40 years, but at other times he doesn't recognize her and instead is in love with another patient he met at his nursing home. Meredith happens to be walking by the room as he's yelling for the other woman, and because she's way better at dealing with these situations than Alex she manages to diffuse things somewhat. At the end of the day Alex tells Derek he's decided to leave the trial and advises him to pick Meredith to assist and forget all of his excuses that he can't work with his wife on something this personal. Derek realizes he's right, so Meredith gets the job from here on out.
It turns out to be a pretty good day for her all around because she also realizes that Cristina is not just back, she's Back. Cristina and Jackson spend the day competing to assist Teddy on a bypass surgery, and their one-upping and arguing gets more and more heated until Jackson swings below the belt and points that Cristina hasn't gotten a lot of practice these past couple of months, has she? Cristina runs off, so a freaked-out Jackson finds Meredith to console her. Once the girls are alone, though, Cristina reveals that she's completely fine but knows this will totally win her the job. Meredith is slightly appalled but mostly delighted to see that Cristina seems totally back to her old self, underhanded tricks and all.
Bailey has become a Twitter fanatic, and she's been live-tweeting surgeries to the delight of Lexie, April, the other assembled residents, and apparently doctors all over the world. When Richard finds out he of course hits the roof though he obviously has no real idea of what this "Tweetter" entails, and there's a lot of comic relief in the form of him trying to use the correct lingo and failing spectacularly. When he realizes she's tweeting against his specific order to stop, he runs into the OR to yell at her but his lecture is put on hold when something goes wrong. Lexie surreptitiously keeps tweeting as he and Bailey work; when Richard realizes it he hollers at her to stop but of course she's just gotten a suggestion from another doctor as to how they can fix whatever complication is happening in this poor patient's innards. Another hospital nearby tweets that they have what Bailey needs to successfully complete the surgery, so she takes off for a short helicopter ride to go pick it up. This conveniently leaves the others all with nothing to do in the OR, so Lexie finally starts asking Richard some questions coming in from other docs. His desire to teach (and, let's be honest, to show off his surgical brilliance) finally overcomes his distrust of this newfangled technology and he of course winds up getting really into it. After the surgery he even starts combing all of Ellis' old journals to find more information for Bailey to tweet. It remains to be seen if he'll go so far as to figure out how to work the mystifying Twitter himself one of these days.
Arizona is having a hard time with the fact that Callie slept with Mark while they were broken up, but assures Callie that she wants to be involved with having the baby. Mark also assures Callie that he wants to be the dad and not just the "cool uncle," though he realizes this could royally screw things up with Lexie and spends most of the episode putting off telling her about the sticky little situation. In the meantime, Callie goes for her first doctor's appointment (with both Mark and Arizona there for support) but once it's over and the two of them leave, she freaks out that something might be wrong with the baby. Her doctor isn't terribly amused at first since she's being bombarded by suggestions from all three doctors about how to do her job, but then she finally seems to come around when she sees Callie sobbing to Mark about how she doesn't want to screw up the kid. She brings in some extra-fancy machine that enables them all to hear the heartbeat even though Callie is only a few weeks along, and all three of them are over the moon. That night, Mark finally works up the courage to tell Lexie, who is not nearly as pleased with the news as the rest of them are, and she storms out after asking how he could do this to her a second time now. Seriously, it's some pretty spectacularly bad timing that when things start to go really well between these two, some Sloan offspring appears out of the blue to crash the party.
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Jazzy music ushers in another Seattle dawn, and as Mere turns off the alarm and slowly gets out of bed we see Derek already at the hospital, preparing for surgery. Meredith's surprise to see his side of the bed empty clues us in to the fact that he totally snuck out without waking her, and she VOs that doctors practice deception all the time and give vague answers to hard questions. Derek does a scan on his patient and speaks into a small recorder that this is patient No.1of his Alzheimer's clinical trial. Meredith VOs that the placebo has to be the doctor's greatest deception.
Alex tapes a hand-written sign up on the door of the OR before he goes in and OH GHASTLY HORROR NIGHTMARE GAH NO WORDS LAKSJDFOPASIDJF [THUD] it warns that the patient inside is awake. The look on the patient's face is that of controlled fear, though he's trying very hard to be calm and tells Derek he's okay as Derek fires up the drill. Alex then rips open the envelope that contains the medicine and a letter saying that this patient is scheduled to receive... the placebo. It's quite a downer of a start to the study. Meredith watches, pouting, from the gallery as she VOs some more about placebos and how doctors tell themselves that patients who receive them will feel better anyhow, which tends to help when all you're doing is actually leaving them to die. This last line kind of lingers over her scowling face, and it seems a tad disproportionate since it seems to imply that Mere's been left to die when really she was just left to not participate in the trial.
We join Mark and Callie just after she has told him about the pregnancy; he's still in bed but she's fully clothed and just hanging out on top of the covers, which perhaps is too little too late. Mark's shocked but not displeased by the idea and though Callie is flustered and assures him he doesn't have to be involved, he absolutely wants to be. He goes so far as to ask if she wants to get married but she shuts that idea right down, which is good, but the question causes him to remember the small detail of Lexie, which is bad. He drops his face into his hands wondering how on earth he's going to tell her about this and Callie takes the opportunity to run out, not super excited to think about all of that.
She goes across the hall to talk to Arizona, whose puffy face indicates that this maybe wasn't the news she wanted to hear on coming back from Africa to profess her love. Callie gently asks if she's ready to talk; it's now Arizona's turn to be angry and it's kind of a welcome change, though of course what I really hope for is for them to work things out like adults and for their storyline to remain consistent. Arizona admits she wants to yell some mean things while knowing Callie won't run away, so Callie agrees and Arizona goes on a tirade about how angry she is that Callie slept with someone even though it was while they were broken up. She's also angry that person happened to have a penis, even though she knows Callie is bisexual. Callie tries to make a joke but Arizona is so not in the mood -- a surprise ex-sex pregnancy does generally sober the atmosphere. Callie tells her that she didn't plan all this but as now a wee baby is arriving in about seven months, she has to get to planning. She sincerely tells Arizona that she wants her to be a part of that plan. Arizona tells her that she is in, but she also still needs time to be mad. Seems fair to me, and Callie agrees. Thank goodness this looks like it might be the end of Callie playing the victim. I much prefer these two when they are able to get mad at each other like adults, without the fear of actually breaking up a la Coach and Tami Taylor.