On a lighter note, Owen is smuggling sterile supplies into his locker and totally doesn't see Derek sitting in the dark, watching him. Derek calls out to him but assures him that he understands and as Owen leaves, Derek calls out and says that he has to do something. He trails off at that so Owen asks what is stopping him; when Derek says that it's Meredith, Owen chuckles and calls her, "The other half of the twisted sisters." Derek laughs and tells him that's a rather perfect name, and honestly I have to agree that it's rather brilliant. Owen asks what is stopping him and Derek admits that he'll look like he did this only for personal gain. After a moment Owen replies that no one goes into battle hoping to win a medal, but that you just do the right thing and sometimes that means a medal while other times it means you get killed. Derek asks how he knows what is right, and Owen says that it is whatever the best thing is for the most people. Again, we've watched so much fighting and posturing and excuses from both him and Meredith that it's refreshing to have someone just say something sensible. Owen says that the right thing is the thing that keeps the most people alive, and Derek and his hair ponder this.
It's finally time for Izzie's scan and... Alex is running it? That's what it looks like, in which case I'm not sure why the scheduled time mattered so much. He's being nice -- despite everything he obviously still cares for her well being -- so she screws up her courage and asks if he has moved on. After a moment, he admits he slept with someone, and Izzie closes her eyes and curses him before asserting that they will get through it. She then asks him to hold her hand so she knows he hasn't left, which is all very deep and meaningful on both the scan level as well as their relationship level, but it's also dumb because her arms are up over her head inside the machine. Alex points this out but offers to hold her foot and they have probably the sweetest moment they have had since she got back, even though it's still plenty awkward.
Derek, meanwhile, marches into the Chief's office and though Richard tries to shoo him out, he pulls a bottle of booze out of a brown paper bag and places it on the desk in front of Richard. Richard is absolutely silent as Derek theatrically gets a glass and places it next to the bottle, then opens the bottle and pours a glass. Richard glares at him and asks if he wants him to drink this; Derek answers that he doesn't want that, but he thinks that he will drink it after Derek leaves, even though he'll try not to. Derek adds that he also believes this won't be Richard's first drink today. With that he turns and walks out, shockingly flounceless. I guess even he realizes this is a sad occasion that doesn't require his most self-righteous gait. Richard drops his head into his hand.