Alex tells Richard that there was no problem but Reed thinks the complete opposite. We see her get back from taking Roy to surgery, and she's stopped by another firefighter who asks if they can line the hall for him when he gets out to show their support. She seems to be probably the best at dealing with patients, but she winds up brushing off the firefighter when Charles waves her over to Cathy's bed. While it's kind of abrupt and I think she could have been a tad nicer, I think the firefighter didn't need to look so surprised given that he's used to emergencies and how sometimes there isn't time for chitchat. Fortunately this never comes back up, so maybe after that surprised look he really did get that she couldn't give him an answer right then.
It turns out she didn't need to cut the guy off as Charles was actually trying to get Alex's attention since he was on the phone. Richard is positively incensed to hear that, but Alex tells him (and we see) that he hangs up the phone and comes over to do the crich. Richard won't accept this and yells that he got there after another doctor got there first, and reminds him the patient was dying. Alex rubs his forehead, trying to keep his cool, and repeats that he got off the phone.
Back to a few minutes earlier, he's sewing up Charles as tightly and painfully as he can when he gets a call from a restricted number. It's finally Izzie, and so Alex frantically tapes the extra thread to Charles cheek and goes into the hallway for a bit of privacy. From his side of the conversation and his begging her to wait, it sounds like she has no interest in ever talking to him again. He looks in and sees the commotion at Cathy's bed but it's right when Izzie seems to be telling him that she's not coming home. He tries to get her to tell him if this means "yet" or "at all," and of course this is when Charles starts waving him over. He begs Izzie to give him a number but she's always been a selfish bitch and things aren't changing now, even though Alex is begging her more and more frantically. Finally, though he clearly wants to track down his missing wife, he hangs up on her and goes to do the crich. (And can someone tell me what the difference is between this and a tracheotomy? It seems the same to me, and even the quick internet search I did didn't explain it so that a non-doctor like myself could really understand. All I learned is that this is less invasive, though I have to say from my sofa it looks like exactly the same thing.) After the same scene from before we finally see that he was successful, and Reed again looks pretty put out that he succeeded. Guys, let it go just long enough to be glad a patient didn't die (yet), okay?