Burke is staring at a very full-looking board when Derek walks by. He looks up from texting on his Blackberry to comment that it's a mess. Burke denies it, but Derek is absolutely delighted to tell him that the OR being overbooked means it's a mess. He mentions there being a couple of more hours to pull the trigger on the Siebert liver, just as the hernia surgeon who had his surgery pushed comes in, angry that he was bumped. Derek gleefully points out that being Chief isn't easy as he takes a phone call and walks away. Burke scowls like a pro.
Meredith is escorting Mr. Hubble to the ER, and playing Twenty Questions to guess why he'd ingest the doll heads. It wasn't to attract attention, nor any other reason she has come up with so far. When she asks again why ten doll heads, he tells her that eleven would have been too many, like it's the most logical thing in the world. I keep feeling a bit uncomfortable about this guy being mentally competent to okay his own surgery, but I'm pushing that aside for the story (or assuming they're allowed to do what they need to since his life could be in danger).
Once in surgery, Bailey pulls out a head and, to the shock of everyone present, lovingly gives the doll's history. At everyone's surprised looks, she challenges them about anyone having a problem, and declares that she both likes and owns Judy dolls. Burke breaks up the love-fest (and the absolutely disgusting intestinal special effects that they insist on showing) to pull the interns for the various Siebert family members. When Bailey is left just with Meredith, she asks if Meredith knows what's strange. Meredith: "We haven't had enough strange?" Bailey just tells her the doll looks like Meredith, and then throws the head in the bowl with the other decapitated, bloody craniums. Ew, does that mean he wanted to eat her head when they were in the elevator? Thank goodness she's at least marginally larger than one of the actual dolls. It's not a lot, but it's enough.
The original organ donor of this episode has arrived at the hospital, and George and Olivia take her into the ICU until the harvest team can come and collect her. (So to speak.) Olivia mentions that their dead patient's family has been found and will be there soon. They don't know the bad news yet, because she thinks it's better to hear bad news firsthand. She continues to turn the knife, saying that's what she would like. "Get some answers. So I could get on with my life." George ignores this pointed comment and continues to examine the body. When he touches the patient's chest, she reacts. He and Olivia try again, and they realize that she is decerebrate, which in turn means her brain is still alive. The transplant team arrives then and brushes it off, saying that death is imminent and that her cortex is dead so the stem will follow soon. George protests, but the team takes her away, insisting she could die on the way to surgery. The guy sounds quite jolly about it, which is just alarming. This episode isn't the best sales pitch for organ donation, what with her still being alive and all.