Cristina drags her ass up to Owen, standing at the surgical board, whining about having been woken from a nap. He's first surprised and then glad she got the rest, and then shows her their surgery on the board. It turns out it's a huge one that could take 10 to 15 hours, and he happily tells her to gear up. She beams and tears out to get ready, but just then Derek walks up and asks for a favor.

Lexie and Cristina and their hardcore lumpy asses walk down the hall, and the ladies each give each other a nod and smile of respect. Cristina only feels good for a moment, though, because the second she hears Hunt call her name she can tell that they aren't going to actually do the surgery. He tells her that Derek needs the OR, and she shuffles off, mumbling about having put on the diaper. Hunt seems shocked that she actually did that, and I'm shocked that he's shocked -- I figured that's what he knew she was going to do, and how can he still be surprised?

Derek is at the microscope again when Mark walks in, saying he heard he needed the support. Derek is surprised, not really in a good way, but Lexie tells him he needs an experienced surgeon to talk to, and he can't say no because she's in charge and she's prescribing it. He actually accepts this and then thanks her, heaves a big sigh, and makes his first cut. Alarms go off and everyone nearly panics, but then Derek says that the cut was successful -- one down, a whole bunch to go.

Alex and Reed are working on Derek's other patients -- the ones with things like measly brain tumors, not tumors that have basically grown into five inches of their spines -- but Alex keeps looking at his watch since it's time for Izzie's appointment. Reed finally gets him outside to talk to him and points out how distracted he is, and he should go while she finishes up. Alex bristles and tells her to mind her own business and asks why she even cares, and she says basically it's for Izzie. Girl power? I guess? She tells him there's a girl waiting for him, but Alex counters that she's the one who left and didn't even have the guts to do it to his face, then tries to shut Reed up and get back to work. Reed gives up, but not before a parting shot that this time, he's the one making the decision, not Izzie, and he'd better be at peace with whatever comes from that. It's finally what makes him turn around and stomp down the hall.

Back in Isaac's surgery, Derek makes another cut that results in a ton of blood, some alarms, and lots more panic. Cristina is upstairs in the gallery giving Mere a play-by-play on the phone, while at home Mere follows along with her new wall décor. Derek freaks out as they think they are losing him, and says they should have cut the cord. However, things calm down and it turns out everything is still fine. Derek steps back, and Lexie realizes something is wrong but not what, exactly. Derek yells at her to take off his mask and as soon as she does, he vomits on the floor. Wow, I hope none got in the open spinal cord right there. Everyone is kind of in shock, and Lexie rubs his back.