Richard is talking to Derek, trying to assure him that what Ellis meant by cutting him off at the knees during the meeting is just that she wants him to use his full potential. And she has Richard to serve as her PR lackey, smoothing all of her rough edges with her underlings. Mere walks up as Richard reminds Derek that he used to talk about doing a clinical trial, but Derek grumps that he has no time with a baby on the way. Richard tries to press that he should think about it, and then walks away. After some uncomfortable moments waiting for the elevator, where Meredith brightly says hello and he actually just grunts back at her, he declares the elevator to be broken and leaves. She gripes about him being an ass and walks off the other way. We know the elevator is just HEARTbroken because it hasn't had the chance to host the emotional hills and valleys of the Saga of Derek and Meredith.
Jackson is working the ER with Owen, and they are called into action when a dreadlocked, heavily tattooed, female cokehead is brought in mid-OD, unconscious and convulsing. They need to shock her to get her heart working and then move her on to the bed, and when the camera pans to her face -- featuring multiple piercings -- we are all shocked to see that this is Lexie.
Mere walks up to talk to her mom and sees her holding court in front of the press, telling them that they will get to see her use the Grey Technique during a surgery later, which will be better than some boring interview. Mere beams with pride and then asks Ellis if she could scrub in and see the magic firsthand. But while Ellis loves the adoration of her colleagues and public, she seems to have no use for it in her daughter and thinks that if her focus is cardio (!!) she needs to be doing a cardio surgery. She brings up that Cristina is doing a solo surgery and Mere defends that it came in overnight or else she would have gotten it. With quite a bite in her voice Ellis reminds Mere that she was "busy" getting engaged instead but now that that is over, what does she want to do? You know, now that her pesky personal life is out of the way. She pointedly asks Mere if she should ask Callie to give her the surgery and Mere immediately assures her she can get Cristina's surgery all on her own, which is just what her mother was trying to have happen all along.