Once Lexie comes back all cleaned up, Mark tries to tease her but she shuts him right down and says it's not funny, and that if it gets back to the Chief she's as good as gone. Mark thinks that it's all in her head, so Lexipedia starts listing off various other hospital mergers and the number of residents let go in each situation. Mark stops her and tells her to get a grip. "You deserve to be here. Act like it." She agrees and leaves as he yells after her to clarify that he meant after she gets some sleep, but she just skips off.
Meredith suggests to Cristina that they get some sleep before rounds but predictably, Cristina thinks sleep is for wimps and would rather try to get in an extra trauma. Alex bolts in and hurriedly whispers, "Don't say anything about the wig," right before Izzie walks in and declares that she is back. Mere and Cristina both step back with complete deer-in-the-headlights eyes. Izzie doesn't seem to notice and claims the first trauma that comes in, but after a moment of silence realizes they are staring, though she thinks it's a good thing. "It's amazing, right?" Cristina and Mere agree too heartily, and Alex wants to know what was wrong with her own hair. Izzie declares it "peach fuzz chemo hair" and wants to keep her patients at ease. Cristina murmurs to Mere that she looks like a Stepford Wife but Mere warns her back not to stare, talking like a bad ventriloquist through sort-of stationary lips. Bailey runs in as there is a patient coming and they all start screaming to claim it. Bailey tells them to make the decision themselves as she's no longer chief resident, but when they can't do it she grabs Alex. Izzie's interns then see her and welcome her back, though they seem a little stunned -- whether it's from her being back early or her wig, it's not entirely clear.
Derek, having not been talked out of it by Mark, storms into Richard's office to say they need to talk. Richard yells back that he's busy and when Derek demands to know what's going on in his department Richard loses his shit and yells, "When it's appropriate I'll consult the people I need to consult with!" Derek is livid and rightfully points out that he's the one that saved Richard's ass and that when he was offered the job, he went to Richard out of loyalty. Richard, however, is just about fully detached from reality at this point and claims that Derek was just trying to look good before stealing his job. Who is this guy? He's so scared he's become an angry Richard clone. Even when he acted like an idiot in the past, which was plenty, he still seemed to maintain at least a shred of humanity, but that seems to all be gone now. He yells that he'll tell Derek when he's ready and orders Derek never to barge in again as he owes Derek nothing. He declares that he's still the Chief of Surgery, but Derek gets in the last word when he spits, "Then start acting like it," before storming out.