Mere finds Derek at the surgery board and accuses him of sneaking out of the house that morning because he was starting his clinical trial and felt guilty that she wasn't on it. He tells her she's right, but that he didn't feel guilty nor did he sneak out. So... what was she right about, then? I guess the obvious, that his trial started that day. Meredith is even more offended by the situation when she realizes Alex won the job of assisting on this trial. Derek just tells her that Alex made the best pitch for the job. If she were a cartoon, steam would be coming out of both of her ears right now but Derek just kisses her and heads off while she yells at them.
Derek's next patient is Daniel, and Daniel's wife is the always-awesome Rose from Lost. He's having a good day and is able to joke with her and the doctors, and Rose is anxious to know, if he gets the medicine, how soon will it help his slipping in and out of reality? Derek doesn't make any promises and reminds her there's a two-year follow-up process but she's understandably a bit desperate and asks if this might reverse his condition completely, as it did in some animal testing. Alex decides to field this answer and while he's not unkind, he's quite direct as he reminds her that human reactions could be different. Derek comes in to play Good Cop, and reminds her that right now the most important thing is that they stop the disease progressing; he then tells them that Alex will be able to answer any more questions they have leading up to the procedure. Poor Rose is trying to stay cheerful but this is obviously one heavy burden she's been shouldering.
Out in the hall Derek tells Alex that in a clinical trial things are a little bit different, so he can "paint a rosier picture" (i.e. charm the pants off of them with luscious hair and a disarming grin while sticking only to the positives) when consulting with them. Alex doesn't want to give false hope but Derek paints a bit of a rosier picture himself and says that they didn't give Rose any false hope. Instead, if she thinks her husband has a better chance of getting better, she'll be a better caregiver and that in turn could possibly lead to the procedure being more successful.
Richard finds Bailey in the cafeteria and though she protests that this is her milkshake break (and apparently a Twitter break as she's clicking around on her Blackberry) he lays into her for broadcasting her surgeries. She thinks it's not a big deal and assures him that the patients have to sign a big release form before they go under saying that it's okay. I'm a little confused about how the hospital lawyers could have put together a Twitter-Surgery Release and not consulted the Chief of Surgery about it, but maybe Bailey is also a legal genius and was able to do it herself. The woman is totally awesome, we don't know. She assures Richard that if the patient codes she stops tweeting but argues that it's a great way for residents the world over to ask questions and learn about how surgical decisions are made. We've already well established that I am an old lady and a fuddy-duddy but I can't help but think Richard has a valid point about this potentially turning into a nasty lawsuit. However, the interwebs have informed me that live-tweeting surgery has already happened in the real world, so I'm going to have to just go with it and get with this modern tekmology hoo-ha. Bailey thinks Richard just doesn't understand it and he tries to argue that he does, but finally she gives him "Bailey eyes" long enough that he concedes he doesn't, but promises to look into it and in the meantime, she's not to do any OR tweeting.