If you are a doctor at Seattle Grace, you either go kookoo for Christmas or you are a bona fide holiday hater. Izzie falls into the former category, and the rest of the gang try to accommodate her since she's all depressed about Alex. They also help Alex study for his practical exam, which of course causes Izzie to pout and whine and yell at all of them. She finally comes around and decides to help, too, with only a tiny bit of crying. Cristina, meanwhile, is even grinchier than you may have expected -- going so far as to make fun of Burke in his own operating room for his display of Christmas spirit -- but finds a little spirit of her own with the help of a reluctant young heart transplant patient whom she teaches to believe in medicine, if not Santa Claus. Other patients include a man whose brain surgery changes his personality for the worse, much to the dismay of his family; and a woman with some incredibly overbearing relatives, whose ulcer surgery has been put off for so long that her insides perforate. And finally, the moment we all (well, some) have been waiting for: McDreamy tells Addison that he's still in love with Meredith. Merry Christmas!
Mere arrives home late one rainy winter evening. Christmas lights twinkle inside her house as she VOs, "It's an urban myth that suicide rates spike at the holidays. Turns out they actually go down." Through a window, we see Izzie putting the final touches on an enormous Christmas tree. MereVO: "Experts think it's because people are less inclined to off themselves when surrounded by family." Mere opens the front door and steps into a winter wonderland that would make the Scientologists weep. George walks over to stand next to Mere, and whispers, "It looks like Santa threw up in here." Mere tells him to just go with it; they're "being supportive." Izzie tears herself away from her tree to ask what they think. "Did I go too overboard? I know sometimes I can go overboard." Mere and George say it's great, just great. Izzie gushes, "Oh, yay! I LOVE CHRISTMAS!" Mere and George exchange glances at this psychotic display of Xmas kookoopants. MereVO: "Ironically, that same family togetherness is thought to be the reason that depression rates actually do spike at the holidays." Izzie busies herself scattering jingle bells all over the already-bedecked mantle, and Mere adds, "Yeah, okay. Izzie doesn't count." I'd like to go on record as vehemently disagreeing.
Cut to Burke's. Cristina walks in to find a much more subdued scene: Burke has bought a tabletop tree, which he says he thought they could decorate together. Cristina acts like he's just asked her if they could shove bamboo underneath each one of her toenails, together, and cuts him off: "I'm Jewish." Burke's like, "Seriously?" Cristina reminds him of her stepfather, Saul Rubenstein. So, actually, Cristina is: a) not Jewish, just making shit up to get out of decorating a tree with her hot boyfriend; and b) kind of an asshole. Burke says oh, right, he forgot. Cristina and her Christmas-sized chip head out the door.
Bailey leads rounds, doing the pregnant-lady waddle as she goes. George and Mere snark on her: "Look at her! She's almost as wide as she is tall!" "Are her ankles swollen?" Izzie asks what's going to happen when she goes on leave. Cristina: "Leave? She's going on leave?" Mere: "What do you think happens when people push babies out of their vagina?" Hee. Alex says they'll probably just leave them unattended, see how much damage they can do. Izzie: "Yeah, well, you would know." So, what, is she still mad at Alex? THE ENTIRE WORLD couldn't tell. Izzie then says they should all get Bailey a Christmas gift for the baby, or organize some kind of Secret Santa thing. Cristina starts to protest, but George and Mere shout over her that a Secret Santa thing sounds great. They turn to Cristina and tell her they're being supportive.
McDreamy catches up with Mere as they walk through the halls, and she asks if he's okay. McDreamy pulls a longer face than John Kerry's and says he's fine, it's just the holidays. Mere gets all sad, too, and says she does know, and follows him into the hospital room.
First patient: Tim Epstein, 38, fell off the roof of his house stringing "Hanumas" lights. The room is filled with Tim's children, who are climbing all over Tim and festooning him with toy dinosaurs and the like. Tim is very good-natured about all this action, and tells the Gang that the good news is, his head broke his fall. Mere reports that there are no visible deformities, but Tim is having some focal left-arm weakness, and his head hurts when he laughs. One of Tim's kids bounces a toy off McDreamy's face, which makes everyone laugh. Another one announces to Bailey that he knows karate; Bailey looks a little scared, and says Tim might need some quiet time. Tim says they're fine, all five hundred of them, and he doesn't want to miss out on the holidays with them. McDreamy orders Izzie to take him down for a CT, so I guess he's getting some peace whether he likes it or not.
The next patient they visit is Nadia Shelton, 41, who is in for excision of a gastric ulcer. Nadia's family is also all there, and they are loud and annoying. The Gang is accompanied by Webber, who apologizes to Nadia for the inconvenience: her surgery has been rescheduled for three days now. Nadia's overbearing mother gripes about having to watch her child sit there in pain for three days, and some other relative joins in. I can already tell that this family's scenes are going to be the ones I "accidentally" skip over. Webber explains that they have a lot of trauma cases at the holidays, all of which have been more urgent than Nadia's ulcer. Nadia's husband says, "Are you saying my wife's not important? Is that what he's saying?" The rest of the family starts yelling all at once, while Bailey and Webber try to calm them down. It doesn't work. I want to kill myself. Webber finally gives in: "ALL RIGHT! Dr. O'Malley, prep [Nadia]! Her surgery will happen this morning." The family all cheer, while Nadia kind of cringes with embarrassment.
Bailey tells Alex to cover the pit: all the holiday idiocy he can expect there is her gift to him. Heh. She's about to assign Cristina and Mere when Burke runs over and tells her they've found a donor for a heart transplant patient of his. Cristina gets it, and Mere and Alex walk off bitching about it. Alex tells her that, to top it all off, he retakes his boards tomorrow, and is pretty sure he's going to fail. "Makes today my last day here, and I get to spend it doing stitches in the pit." Aw.
Cristina walks with Burke to their patient's room. Burke asks her when Hanukkah falls this year. Cristina says she has no idea. Burke, who is entirely too sweet, is like, "Oh. Well, if there are any more traditions you want me to be aware of..." Cristina cuts him off again, and says she hasn't observed any kind of religious holidays since she was old enough to know better. Burke doesn't know what to do. I can think of a few things, starting with the word "boot."
Their heart transplant patient is a young black boy named Justin. Burke tells Justin and his mother that he's there with great news. He says they have a heart for Justin, and he'll operate this morning. Justin's mom starts to cry: "You hear that, baby? Santa Claus is bringing you a new heart for Christmas." Justin doesn't seem to like this idea at all, and tells Burke to tell Santa's fat ass to give it to someone else. "I don't want it!" Damn! Burke just stands there while Cristina grins evilly behind his back. Maybe she and Justin should get together. Credits.
When we come back, Justin's mom tries to laugh it all off, and tells Burke that Justin's just tired today. She seems very sweet, and clearly loves her son more than life, but also kind of clueless about what he's feeling. Justin says he's tired every day, and hates Christmas every day, and doesn't want another stupid operation. Burke tells him that he knows operations are scary, but he needs this heart, because he wore out his last one. Cristina's like, "Wait, what? Last one?" Burke explains that Justin had a heart transplant as a baby, but his heart hasn't aged as well as he has, and asks Justin if he understands that. Justin says he doesn't care; he doesn't want it. Burke asks if he can tell him why not, but Justin just crosses his arms and looks away.
Bailey finds Webber at the surgery board. "Anxiety attacks, aneurysms, and ulcers," Webber says. Bailey: "Must be December." Webber's secretary walks up and tells him that Adele called. He tries to brush her off, but the secretary interrupts, "She knows you're not in surgery, and she says, quote, 'We are going to our niece's school pageant this morning. You have known about it for months, and after what you pulled on Thanksgiving...' Then she started using a great many words I don't feel comfortable repeating." Webber says he has seven surgeons on vacation. Secretary: "Then there was something about divorce." Heh. Webber reluctantly tells Bailey she'll have to cover his ulcer excision. Bailey, stone-faced, says yes sir, she will.
Mere and Alex meet a patient in the ambulance bay. Mere tells Alex he's going to have to fight her for it, and Alex gets this sad look on his face. He tells Mere it's all hers, then walks off. Sadly. Did I mention he is sad? Because he is. Sad.
Cut to McDreamy and Addison. She's looking at a catalog as they walk, and starts yammering about some handmade Scottish blanket she's going to get his parents for Christmas. "It says please forgive me for hurting your son, except in fabric!" McDreamy reminds her that his mom loves her. Addison says she used to, but she has a lot of ground to make up for with these gifts. She asks what he thinks, and he's all, "I don't know. Whatever." Addison can't believe he's not more excited, because he just loves Christmas shopping! McDreamy says he's got a lot on his mind, and is really not in the mood right now. Addison tries again: "Okay, well how about French food and Scottish catalogs, tonight, around nine?" McDreamy crawfishes around about how it depends on what time he can get off work, et cetera, and when Izzie interrupts them to say Tim's scans are back, he takes off. Poor, clueless Addison has to just stand there holding her catalog and watching him go.
Nadia's room. It is still mayhem in there, with people playing GameBoys and watching TV too loud and