Once they are in the OR staring at Justine's brain, Derek lectures Lexie for not having gotten her in there sooner. He's kind of pissed to hear that she didn't even finish the book but Lexie admits she told her how it's going to end, and she finds it totally stupid. As she complains about how Justine screwed up her own story, Derek comments, "Wow, you're 15 right now," but like Mark before her, Lexie either ignores or doesn't even hear him. She wants to tell Justine as soon as she wakes up just how awful her decision is, and Derek points out that it's none of her business. But Lexie's a smart cookie and just shoots back that this is like all of his impossible patients -- if he thinks there's a chance he can change the way their story ends, then he has an obligation to at least try. And while I think it's ridiculous to compare someone dying of an inoperable brain tumor to an author writing a romance novel, I give Lexie major points for being able to use Derek's logic against him. He also has to agree with her, though I suspect he does that just to shut her up.
Bailey is scrubbing in when she is joined by Meredith; when Bailey asks her if she double-checked the labs Mere can't help but sound kind of annoyed when she tells her of course she did, and Bailey just defends that she doesn't want any surprises. Mere then casually mentions that Mrs. O thought she would be doing the surgery, and Bailey acts kind of like Mere just suggested they use hot pokers and no anesthetic to get this procedure done. Mere insists that Bailey herself taught her this procedure but Bailey just quips that she thought she taught Meredith a lot of things. Oh lord, ENOUGH. Bailey, you now have to work together, which means you have to LET IT GO. Meredith proves once again, however, that she is calmer than me, and rather than yell back at her superior, she changes the subject to her hearing the next day and how she has no idea what to wear that would be right to convince the judge how desperately she wants her daughter back. She talks about feeling useless and frustrated, and then comes back around and tells Bailey that at least here, she isn't useless because she knows how to do the procedure and when to double-check labs. Her approach seems to work, and after appraising her a moment agrees to let her do the surgery.