Well what do you know, this week got interesting. By far the weakest part was stupid Derek, so we'll start with him. He's been doing nothing but drinking and wallowing since Jen died (and it sounds like he's also now named in a lawsuit over her death) and he finds out that he's had more patients die than live. He takes off to go wallow some more, defying the Chief's ordering him to stay and operate. The Chief, Bailey, Meredith and Crisitina have been working on three siblings who all have a gene for some horrific type of stomach cancer, so the two sisters have their stomachs removed to prevent it. Their brother opts out, and the sister tells Meredith you don't give up on the ones you love and she'll convince him. The Chief then asks Mere to help bring Derek back, and fesses up about him having a ring to convince her that Derek doesn't really want to be left alone. But Derek has moved all of his things back to the trailer, and drunkenly yells at Meredith with some pretty spot-on but cruel comments and then bats the ring off into the grass somewhere to prove he wants to be alone. Mere promises she's not giving up, but I say let him be -- the show was better without all of his whining and posturing this week.

The Chief is acting like a total child -- literally like a little kid who has had a toy taken away -- and keeps sniping at Bailey for going into peds. She winds up calling Adele and telling on him, so Adele shows up to give him the reaming he needed and also to give Bailey some words. Because Adele is awesome and always right, they end up making up.

Alex, Hunt and Arizona get a patient who supposedly has epilepsy, but Alex manages to catch that it might be a heart problem. They do a risky procedure and Alex kind of freaks out, but it turns out he was totally right and saved the girl's life. Arizona congratulates him and calls him the resident to watch, and he runs gleefully to go tell Izzie. It's one of Alex's best moments ever -- clearly he's just used to never being praised or encouraged and it might be what he needs to really make it as a doctor. Unfortunately he's going to be busy with some personal problems really quickly.

Izzie is still hounding the interns to diagnose Patient X, and while it's achingly obvious that it's Izzie herself, this is Seattle Grace, so no one picks up on it. They finally (mercifully) land on a diagnosis -- Izzie has melanoma that has metastasized to her brain, and even with treatment she has a 5% chance of living. She doesn't tell Alex because she doesn't want to bring him down when he's so happy, and she doesn't tell George even though it seems like George might suspect the truth about what is going on. She winds up admitting it to Cristina, since Cristina will be able to handle it. And while it seems that maybe she might try and keep it a secret, I have to guess that with the aggressive treatment that actually won't be possible, so we can have an actual storyline going forward instead of just yet again one person not telling another something really important as this show has fallen back on so many times. Fingers crossed, at least.