Meredith approaches Rose who, upon seeing her maybe-not-really-kinda rival, knocks an entire file to the floor. She stammers that Meredith is intimidating because of the Legend of Derek and Meredith. In explaining the Legend (which Mere pooh-poohs), she lets it slip that Derek is selling the land, and even moronic, naïve Rose knows it's because of Meredith even though Derek won't admit it. She tells Mere that she really likes Derek and Mere intimidates her, but Meredith smiles genuinely at her and assures her there's no legend.
The scenes with Alex and Ava back at the house are so hard to watch, I'm not sure I can do them justice. Alex keeps prattling away, trying to engage Ava in the movie, pretending that the woman next to him isn't a shell of a human staring into space. He can't ignore when Ava starts to cry, however, and then in a tiny voice she apologizes and admits she thinks she wet herself. Alex seems taken aback for a second, but assures her that it's okay. As he kisses her on the forehead, she tells him she promises to try and do better. I know we've set up Alex to be the poor, guarded, wronged kid from the horrible, alcoholic, broken home, but even that doesn't excuse the fact that he's basically willfully ignoring how badly she needs professional help.
Jeremy is sitting on Beth's bed while behind them, Beth's mom sits in the chair and watches them with a knitted brow. She brings up a woman from their support group but Jeremy tells Beth that she died, and relays details from her husband that she didn't even know him on the last day of her life, and she was in extreme pain. I know Derek is horrified at killing so many people but given how they'd go naturally a short while later, it's really not the worst thing that could happen. Beth says basically that: she and Jeremy are lucky that they don't have to worry about that happening. She assures him that the surgery will work and then adds that if it doesn't, "At least we'll die quick." They touch foreheads, but Beth's mom has seen enough and asks Meredith what happened to the idea of changing Beth's room. Beth's face darkens like a thundercloud as she tells her mom that this room (down the hall from Jeremy) is great. Meredith takes note of the situation and tells Mrs. Beth's Mom that there were no more rooms available, and Beth mouths a grateful thanks to her doc. She then turns to her mom and tries to get her to leave; when the subtle approach doesn't work Beth says she wants to kiss him without her watching. Just as her mom protests, Jeremy's eyes roll back in his head as he's hit with a seizure.