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.
Three days after we last left our fighting doctors, Meredith is talking about shadows. "Every surgeon I know has a shadow. A dark cloud of fear and doubt that follows even the best of us into the OR." Derek looks like a homeless man, unshaven, unbathed and surrounded by garbage on the couch, eating out of a box of cereal. Meredith, Alex, Lexie and Izzie are watching him and Meredith is trying to defend her boyfriend when Alex says that he is fried. She points out that he lost a patient and was hit with a lawsuit (presumably about said patient) in the same week. Alex is just pissed that Derek is eating Alex's cereal, but Izzie dreamily defends him, saying, "Something huge and life-altering happened to him and he's taking stock. Figuring out his next move. We shouldn't judge him." Oh, but we totally will, and we'll judge you too, Blondie. When both of you aren't such jerks anymore I'll see about revising that policy. Meredith finally declares them all cowards, I think because they won't talk to the stinky form on the sofa, and she walks up to compliment him for eating and to suggest a shower. Her hair looks as bouncy and amazing as his looks greasy. His drama really agrees with her locks, at least. She asks if he's going to go into the hospital and he mopes that he has to go for the deposition, to explain how he killed someone's pregnant wife. Meredith tells him that's good and then corrects her meaning, but he just glares at her, shoves the cereal box at Alex, and storms off while Mere makes excuses that he'll be fine.
"We pretend the shadow isn't there, hoping that if we save more lives, master harder techniques, run faster and farther, it will get tired and give up the chase. But like they say, you can't run from your shadow." Hunt proves her point nicely when Cristina comes up to him, sleeping on a gurney, and leans in to wish him good morning. He awakes with a start and pushes Cristina across the hall and into a cart full of supplies, cutting her arm. She greets him with a put out, "Good morning!"Hunt works on taping up the wound on Cristina's arm while she makes small talk about the time she dreamt she was falling out a window and holding on to some curtains. She woke up to find she was actually pulling out Meredith's hair. He doesn't really answer since he knows she's trying to make light of what happened so she starts to talk about the trauma that they have coming in. Hunt, though, orders her off of his service despite her protests. When Meredith comes in and asks what happened Cristina brushes it off, saying she tripped and fell, and she's fine. Hunt jumps in to say that she's not, but he doesn't fess up to what really happened and once he leaves, Cristina just tells Mere there was an accident and asks what's up with her. Mere tells her that Derek won't get off the couch and Cristina groans, "Ugh. So the weaker sex."