Burke and Patricia are going over various chiefly matters when Meredith shows up with Hubble's x-rays to request an OR for the emergency surgery. They all look at the film in sick wonder and Patricia exclaims, "I can see their little faces!" Then, in a tiny voice, "'Help! Let me out!'" More screen time for Patricia, please! Burke doesn't crack a smile and just tells Meredith to bump the hernia operation, but not to tell the bumped surgeon what it is they're removing in the new surgery. Clearly he doesn't know yet how absolutely nothing stays a secret at Seattle Grace.
Burke then walks into the Chief's office and finds Adele shuffling through files. She explains that Richard needs to take things home to obsess about if he can't do it at the hospital, and she'll be done in a moment. Pat happily waves hello before leaving. Adele then starts to muse about how it's always something when you're Chief, and the work never stops. Burke just sits down at the desk wordlessly and basically ignores her, going through paperwork while she talks. That is, until she mentions her initial feeling of relief when she heard about the tumor. She thought Richard might be finally forced to retire, which perks Burke up quite nicely, and she calls him on it. She sweetly continues that it's something they both want. She then tells Burke he's perfect for the job. "Unattached, obsessive. This hospital, this job, it's enough for you, isn't it?" He still doesn't actually say anything to her, and she walks out. I would think that the Chief should also be able to handle people, which seems to be a significant glitch in his circuitry, but I guess that's just me.
Thunder again ominously rumbles the transition to the next scene, where clearly Izzie and Alex have just told Scott what's going on. Scott muses that counseling has told him not to force the decision, because you'll just know in one moment what's right, and it should be easy. Alex knows that this is a tough position, but Izzie perkily tells him about how the liver regenerates and he'll be hunky-dory in a couple of months. Alex demands to see her outside. I respect that all these doctors at least confront each other in the hall, but they might work on their responses when getting a colleague into the hall. Right now everyone's about as subtle as if they yelled "I NEED TO TALK TO YOU ABOUT HOW HIS DAD'S AN ASSHOLE" or the like and then slammed out of the room.