Upstairs, Richard has just told Jack, the heart transplant patient, what happened to his daughter. He's got tears in his eyes, but he seems too stunned to let them fall. He says, probably not for the first time, that he can't understand how it happened. Izzie tells him quietly that it would have been quick and that she probably didn't feel anything. After a moment, Richard gently tells him that Erin was a donor, and that as next of kin he could instruct that he receive her heart; she was a perfect match. Jack just tells them to go away, and when Richard tries again, Jack repeats desperately for them to leave. Realizing that he needs to lay off, Richard tells Jack that George will take him up to see Erin, and quietly leaves.
Elsewhere, Derek heads upstairs to lots of smiling glances and giggles from various female staffers, as if he's in an Axe Body Spray commercial. He runs into Sydney, who happily introduces herself (officially, as they've both been working there a while) and proceeds to throw herself at him in a fit of overly cheerful flirting. To his credit he takes it very gracefully, more so than Meredith, who is watching from the end of the hall. She turns to Ryan and asks him if he thinks Sydney is pretty. Ryan answers, "Yeah, I like cheerful people." Mere's totally surprised and protests that she can be cheerful, but Ryan tells her, "I think the ashes thing makes that kind of unlikely." From the mouths of babes.
The next person on their list is Bailey; Meredith finds her in the clinic and asks if she would donate some time. Unfortunately she's buried under paperwork on account of her patient cutting off his own foot. She also promised that she'd be home in time to see her son in his Halloween costume. Meredith asks if he's old enough to even know what's going on, and Bailey concedes that he isn't, but she made the promise to her husband. On cue, Ryan comes trick-or-treating. Bailey, appalled at the manipulation, exclaims, "For ears? He's trick-or-treating for ears?" Mere gives a pathetic little, "Yeah," and asks if Bailey will help persuade the surgical nurses since they like her. Ryan chimes in again, "Trick or treat!" Bailey orders him to stop and gives them a scary glare, but finally gives up and agrees to help.
Jack is sitting at his daughter's bedside, crying, and George is trying to be discreet as he waits but is clearly having trouble watching Jack's abject grief. Jack points out that she's warm, and Derek tells him quietly how she is breathing with the help of machines, and that his daughter Erin, the person, isn't there. After a moment, Jack asks for the paperwork, saying they can have her organs since it was what she wanted. George then asks about the heart. In a tiny whisper, Jack breathes, "Give it to someone else."