Ugh. I don't think it's a coincidence that Izzie came back and the episode was the worst they've had in quite a long while, though to be fair there was plenty to not like from more people than just her today. She finally comes back to Seattle after getting Mere's voicemail about Alex moving on, but then acts like she can just slip right in like she didn't totally selfishly run away from her husband and the rest of her life like a spoiled brat. Alex isn't super excited to see her, and clearly isn't excited by her idea to get a job in Tacoma so that the two of them can make their marriage work. They finally talk just a little bit when she's stuck in the CT machine and later when her scans come back clean Alex is thrilled -- so thrilled, in fact, that he realizes that he can make it through the horrible times in life, and that he deserves someone that won't just bolt when things don't go exactly her way. Izzie is crushed by the news, though the fact that she never saw this reaction coming speaks volumes in itself.
Things are pretty testy between Cristina and Teddy as well, after the little matter of Cristina offering up Owen like a trading card. Cristina still wants and loves Owen but admits to Mere she would (and did) choose surgery over love, and then tries to get her friends to admit they would choose the same way so she doesn't look so bad. She and Teddy have a difficult patient but Teddy goes the extra mile to save him so that his career doesn't end, and Cristina says that this proves Teddy understands how important one's career is. Teddy isn't sure she agrees, gets drunk, and spills all to Owen. Because he is amazing, however, he confronts Cristina and tells her he's fighting for her and going to get her to admit that she needs feelings and love that surgery alone can't give to her.
Callie comes down with the chicken pox and Lexie has to treat her on account of Arizona having never had it before. Arizona finally admits to Lexie, though, that she actually lied about that because she wanted to still be in the sexy, exciting phase of their relationship and not move on to the oozing, itchy sores phase. When Mark shows up and helps Callie scratch her pox (no, seriously, not a euphemism) Arizona realizes that if you love someone anything can be sexy, while Lexie, who has been watching the pox scratching as well, realizes she still loves Mark. She goes to talk to him later and he immediately spills that he slept with Addison, and she heaves a sigh of relief and admits to sleeping with Alex. Unfortunately Mark is campaigning to become the mayor of Double Standardville and turns on Lexie, saying that what she did was worse because she's the one who broke up with him, and he was worried because his daughter was having risky surgery. It's pretty disgusting, and Lexie holds firm through the conversation that they're on even ground, but Mark decides he can't speak or even look at her and stalks off.
But even with all of this selfish stupidity going on, Derek and Meredith easily get this week's blue ribbon in that category. Derek's livid about the Chief drinking again and Meredith's hiding it, but when he wants to go to the board she plays the Post-It Card and says she admitted the drinking to her husband, not to the head of neurosurgery. Derek agrees to not say anything but then turns around tries to tempt Richard with booze to see what happens. Richard has scheduled a complicated surgery to prove he's capable but when it comes time to do the surgery, Bailey is there instead as it seems the drink got the better of him once again -- it costs Meredith the chance to do the most crucial part of the surgery as Bailey thinks she's not ready. Derek is still desperate to go to the board but is also worried that people will think he did it for personal gain as he'll surely be made interim Chief. Finally, he blackmails Meredith: if he goes to the board and becomes Chief, the first thing he will do is hire Izzie back. Meredith unhappily agrees, but with Alex dumping Izzie and telling her to move away again, it turns out it might be for naught. Meredith accuses Derek of only wanting to tell on Richard so that he would become Chief, Derek accuses her of wanting to keep his problem a secret so she could do a fancy surgery, and neither of them ever really brings up the fact that it's just not a good idea to have one's Chief of Surgery, whether he's operating or not, be drunk all the time. Regardless, Mere greets Richard when he wakes from a booze-induced nap and has Jennings and the board waiting right outside the office to relieve him of his duties; it looks like Derek's probably going to be running the show, at least for the next while.
We predict the plots of Shonda's new medical show Off the Map.
"Number one rule of surgery is 'limit exposure.' Keep your hands clean, your incisions small, and your wounds covered," Mere tells us. Bailey is doing just that with a patient and narrating to the full gallery that she's removed a tumor and placed catheters in the abdomen to flood it with heated chemo, which will target cancer cells and leave the other ones alone. Is this a real thing? I've never heard of this but it sounds kind of amazing. They then start tipping the gurney up and down and jiggling the poor guy to help make sure the chemo gets everywhere. It's like they're shaking a giant human cocktail.
Upstairs, once Bailey looks up and sees that Callie was there, Callie gets up to leave since she's got a headache and needs coffee. Arizona whispers a saucy suggestion that she knows what would work even better than coffee for a headache, and the ladies head out which leaves an open seat for Teddy... right next to Cristina. The two squirm uncomfortably so it's apparent that they haven't yet addressed what happened the night before (I believe). Teddy comments that she's never seen this "hot chemo lavage" before, but rather than stick to banal conversation about groundbreaking surgical techniques, Cristina just says she thought Teddy was leaving. Somehow between then and now, the Chief asked her to stay a few weeks until her contract was up and Teddy agreed. Mere VO's, "Number two rule of surgery is 'when rule number one stops working, try something else.'" Cristina says that she didn't mean what she said, but Teddy just chuckles and reminds her that she offered to "trade Owen like a horse." Cristina's momentarily at a loss for words but when she tries to apologize Teddy shuts her down and tells her to forget about it. Mere: "Because sometimes you can't limit exposure."
Across town a different fight is in full swing -- this is why I'm fairly sure it's the next day, as Meredith and Derek are having a screaming match about whether or not to go to the board about Richard. In real life, I'm sure would have just happened as soon as Meredith told Derek about Richard's drinking and not waited until the next morning for storytelling purposes. Mere VO's: "Sometimes the injury is so bad, you have to cut and cut big." Derek is yelling that he's going to report Richard to the board, while Mere yells back that this will end Richard's career, and that Derek doesn't give anyone room to have flaws. Seriously, I think "running a hospital while intoxicated" is a bit more than someone who, say, bites their fingernails. I do think that Derek could take the step of talking to Richard directly before going to the board, but on the other hand that never really works with him even when he's not drinking. Mere tells him, "Flaws are unacceptable to McDreamy." He gets mad at her using the nickname but she goes on to say McDreamy is being a "McAss." Derek then asks if he's been drinking since the holidays. Dude, McDreamy can connect the McDots -- they're big enough -- but clearly he's just asking to get to Mere. Would it have been too much for anyone to show logical thought processes or concerns during this ridiculous fight? Mere wants him to admit that he wants Richard's job, but Derek just tells her he has a responsibility to the hospital. He won't admit to any job-coveting and instead says the conversation is over. As he storms out, however, Mere calls "Post-It!" He says she can't do it but she does, claiming that she told her husband, not the head of neuro, a secret about her friend. Seriously, now Richard is her friend? These two have had a complicated relationship the whole duration of this show that yes, has gotten better lately, but I don't know that they've made it to "friends." Dear show: Make up your mind about their relationship but don't make her hate him when it's convenient for one story and "friends" with him when it's convenient for another. My head is spinning. They yell some more but Derek gives, and when Mere smiles at her victory he's overcome by how cute she is and they make out. Honestly, this whole argument scene was so maddeningly stupid, I can't believe I just gave it this much real estate. Mere's pager beeps and she tells Derek that Izzie is coming home and that she has to tell Alex. Derek tells her he won't go to the board or even say a word, but asks her to think about what he said.