In a less action-packed but no less hostile OR, Mark notes that Michael's vocal cords are crushed beyond repair. When George pipes up, Sloane gives him a ton of shit for speaking out of turn. Lexie says his name warningly and he loudly asks her if she has anything to say to anyone in the room. He calls her a coward, so she tells him to shut up, shocking George in the process. On cue, however, Michael starts to crash so they have to start focusing on the actual surgery at hand. In another OR, Vincent is doing way worse than Michael, and Cristina looks on, horrified. At the same time, Derek works urgently on Phil, while Michael's monitors continue to beep ominously.
In a much quieter room, Sarabeth holding Betty's hand, calmly telling her what happened when Betty asks the question once again. Anna walks in, sadly watching her friends, and Sarabeth sadly assures them with false strength that they're all going to be okay.
Derek and Mark come in simultaneously to talk to the women. Derek delivers the news that Phil is still paralyzed, and Sarabeth grasps her friend's hand, which of course Mere notices in a slightly judgy way. Anna then tries to sound neutral as she asks about Michael, and Mark has to deliver the second blow of the day, that he won't speak again. Anna takes Sarabeth in her arms as they both start to cry but try to hold it in. Derek tells them he's ready for Betty when they are done, and as he leaves Richard walks in to tell them about Vincent. Betty again asks what happened and Richard tells them Vincent is stable but critical. He then introduces them to Cristina and pointedly tells them that she will be personally responsible for making sure Vincent lives through the night. Cristina, mollified, promises she'll keep Betty posted but Betty has reset once again and asks what she's being kept posted about and what happened. Izzie quietly explains, and Cristina tries to absorb the news.
Derek finds Rose working on the surgical board and she maturely ignores him completely even as he tells her they need to talk. He tells her she can't behave like that in his OR anymore so she takes a deep breath and admits that she's been acting like this because... she's carrying his child. Derek gapes. But, the most talked-about moment of all the summer commercials turns out to be a big fake-out, as she just wants to make him sweat and bursts out laughing at her little joke. Derek pretends to chuckle along as he tries to breathe again. He tells her he deserves it and can't believe he's talking to her that way; when he calmly tells her she should transfer to a different specialty, she shoots back that he should be the one to do it. Look, I don't like her at all but I admit what he did was totally crappy, and as someone who has been broken up with for an ex, I know it stings like a sonofabitch. But he's trying to be professional while he's performing NEUROSURGERY, for goodness sake. She might try acting like an adult or seriously consider going elsewhere. He says that in simpler terms reminding her he's a neurosurgeon, and she just snipes that he should have remembered that when he repeatedly assured her he was over Meredith. She then stomps off and yells that she isn't going anywhere. Yay for us! Ugh.