He passes Richard in the hall, who ask if he can do a couple of surgeries, but Derek just growls that he's not operating today. Richard starts to plead a bit that he knows he's got the lawsuit and lost a patient but he needs him back to work, "Doing the job I hired you to do." While he finally has adopted the air of being the boss, it's too little too late and Derek maintains he won't operate. At this point, the Chief melts down completely, screaming down the hall and in front of everyone that he's not asking, he's telling Derek. However, he won't back up his words with any sort of action and so Derek just walks out while Meredith hangs her head.
At lunch, Mere tells Cristina about Derek while Cristina complains that Hunt won't even look at her since "he went all Apocalypse Now" on her. They continue to each have their own conversation when the other stops for breath and it's generally repetitive except for one interesting thing: Meredith actually admits that Derek got scalpel happy during Jen's surgery and that now he needs to face the music. I don't know if I really thought she'd ever put that so bluntly. Cristina, meanwhile, is arguing that she's not a wilting flower. Izzie has been watching them and starts to laugh at them, imagining them in a nursing home talking at one another in 50 years. Mere and Cristina stare at her like she's a weirdo for her outburst, but she takes no notice and instead comments dreamily about how much she loves lunch.
Her boyfriend, meanwhile, does paperwork in Beth's room. Alarms notify him that her vitals start to drop and he looks up in confusion -- after a moment, she begins to seize and he calls a code blue.
Richard, Bailey, Mere and Cristina are taking out Tricia's stomach, and when they're done Richard asks how you close things up and Yang says to sew. Bailey interrupts to ask Mere the same question since she believes in stapling instead. The Chief is aghast and totally snotty about it but Bailey defends her choice with some valid medical reasoning and calls using the stapler her specialty. Richard shoots back that he thought her specialty was babysitting children, and he's surprised she's not doing that right now. Score one to Miranda (even though the Chief lobbed her a softball) as she pointedly replies, "Frankly, sir, I feel like I am." I've maintained all season that Richard should do something rather than just bitch and moan about the state of his hospital, and maybe act like a leader, but he's hitting a new low even for him this week. He glares at Bailey but they are interrupted when Cristina feels something bad, and they make a lot of dramatic eye contact as Bailey warns, "Tell me that's not what I think it is."