Lexie pulls herself together and goes to check on Justine, who is groggy but doing well. She knows her name, but when Lexie asks her the date she points out that she never knows that even when she hasn't just had brain surgery, so she needs a different question. Lexie asks, "Why can't Kate choose Nathan?" She's losing her cool again already and doesn't realize at first that Justine tells her that Kate is going to do just that, but once she does realize it Justine adds that it will only be for a couple of more books, and then she'll go back to Alexander. It's too much, and Lexie starts to cry as she asks Justine why she hates Nathan. Why are we even still calling him "Nathan" at this point? Justine loves Nathan because he's kind, funny and honest, but Kate doesn't love him. Lexie is defeated; the only comeback she can muster is that she should, and it's not fair. Justine tells her that she knows, but it makes for a really good read. As Lexie cries, she reaches for her hand and gently asks if it would make her better to work on the book some more. Lexie nods, dries her tears, and sits back down at the computer.
So Callie didn't need HIAB to tell her what was right when it came to Mrs. O; Callie is at her bedside when she wakes up. Unfortunately, she immediately awkwardly launches into telling Mrs. O that she now likes women, and got married to Dr. Robbins, almost died in a car accident, and has a beautiful baby. Mrs. O's eyes fill with tears as she's talking, and by the time Callie finishes her mouth is just hanging open. Callie feels awful and starts to apologize -- adding that her own mother basically disowned her over all of this -- but when Mrs. O can finally speak it's just to ask, "You have a baby?" Oh geez, now I'm starting to cry, as is Callie. Mrs. O wants to see pictures and then can only exclaim and cry in happiness to see the little cutie on Callie's telephone screen.
Owen is now staring at all of Derek's scans when Derek comes in and tells him that the guy whose brain is up on the screen just booked a flight to Seattle; he then challenges Owen to call the guy himself if he doesn't want to allow the surgery. Owen explains that he's not worried about the hospital, he's worried about Derek since he's been through a ton and thinks that trying to play God at this point in time might not be the healthiest thing in the world. Fine, so I'm paraphrasing. Derek just counters that he doesn't have a reputation anymore and that now that he's not going to be the guy who cured Alzheimer's, he can choose what he wants to worry about. He chooses all of these inoperable folks because he thinks he can change their stories and therefore owes it to them to try. Owen asks him if that's not rather arrogant, but Derek just grins that he has a reputation for arrogance. Well, at least he's admitting it.