Derek and his beard walk into the kitchen carrying a bag, so I suspect that he has not actually moved back in yet. She sits down at the table with coffee and toast, clearly unhappy, and he sits down just as glumly and sets a ring box in front of her and gazes at her with puppy dog eyes. She just answers, "No. Not like this." That's a proposal, Derek? Give me a break. Also, does anyone know if this is his mother's ring, that maybe he went and found it in the grass? I don't think so -- as I recall, this one looks slightly different -- but I'm not sure and you eagle-eyed viewers are very good at that. She tells him that it's his first day back (clearly just for our benefit since obviously they are both aware) and that today is about Izzie and his operating on her. She tells him, "You have a gift. And you can do this." He just silently takes the ring back and then grabs his bag, mumbling that he's going to shower before work, for which I'm sure his colleagues will be eternally grateful since it's not 100% clear that he's showered at all up to this point.
Cristina is at work with a turtleneck on under her scrubs, which Meredith notes is ugly. "Not as ugly as the fact that you hugged him..." Cristina gets it and wants Meredith to move on but Meredith won't drop it and repeats that Cristina, the situation, and her boyfriend are all not okay. Alex then joins them and asks Meredith if her boyfriend is okay, taking the ladies by surprise. He explains, "To be cutting into brains today. Is he okay to be back?" Meredith tells him that Derek is fine but this isn't really the crowd for pithy reassurances and Alex points this out, reminding her that he was in the OR when Derek melted down and took out half of Jen's brain. This isn't just any patient, it's Izzie. Does that mean it's okay to slice up the brain of someone you aren't dating? Interesting theory.
Derek, his beard, and the Chief walk by as the three residents walk downstairs. A little ways away Callie is staring into space when George walks up. She's surprised he's not in Izzie's room for the big presentation but he's livid that he didn't know Izzie was sick and that he heard the news third-hand from Bailey, as well as being really hurt that Izzie trusted Cristina more than him. Callie tries to stand up for Izzie but George doesn't want to hear it and just asks for work on her service. He then takes a chart and storms off to fill a patient's room with sunshine and light.