Callie finds Derek putting on a wrist brace and she immediately tries to tell him that he just tried too much, too soon, and that things were too emotional. He cuts off her excuses, though, and tells her angrily that his hand went numb before kicking over a tray of instruments in frustration. Richard walks in and acts like he didn't see that, because it's almost 5:00 and it's time to go to Mark. Both Callie and Derek look stricken that it's really here.
Avery is currently up in Mark's room, going over some more patients with him. He tells Mark that he decided against the reconstruction they discussed earlier but says that Mark taught him a lot, and he thinks he knows what he's doing now. His voice breaks as he adds that the Plastics Posse will live on, "'cause I can take it from here." He walks out as Richard and the others walk in, and a sad song starts playing to punctuate the tragedy of the moment.
Richard explains what they are about to do as if Callie and Derek are just regular, non-doctor loved ones, and Callie tries to stop him since they are in fact doctors and they know. But Richard calmly explains that even if they think they are prepared, they aren't, and their brains can't fully absorb what they are about to do. Talking them through it gives their brains a little bit of time to try and catch up. As he then goes through the steps, Callie starts to crumble a little bit. Richard explains that Mark's living will dictated that if medical procedures would only prolong his death, he wanted them discontinued. Everything about this is horrible and sad.
Cristina looks up at the clock in her OR and notices it is 7 PM. Feeny asks her pointedly if she has somewhere to be but she keeps it to herself and just remarks that it is five in Seattle. Feeny has no idea why this is pertinent and could care less -- he also seems a little bit snippy after the dressing down she delivered earlier, and the two of them just get back to work, silently.
Richard continues explaining that Sloan's wishes were that if he was unable to make a decision, his chosen proxy do it for him. I don't know if that was Derek or Callie, but they seem to be sharing the burden. Avery watches from the hallway as Richard explains that he'll be sedated so he won't be in any pain, and that once the breathing tube is removed it could be moments or hours until the end. Callie starts to cry as the tube is removed, and Mark's raspy breathing is gut-wrenching. Richard leaves them and they sit down on either side of their friend; Callie takes his hand.