Meredith is finally telling Esme about her condition. Esme looks thoughtful, then says they were supposed to go to Venice at the end of the month. "Do you know the story?" Mere shakes her head no. Esme tells her that the story goes, if you ride a gondola under the Bridge of Sighs, you'll be together for eternity. She then immediately tells Meredith not to tell her husband. See what they did there? Esme doesn't want him to know; he's always so worried about who will go first. Meredith says they can't have a relationship built on a lie. Esme is like, "Oh, you young people. It's not a lie. It's our future. I've been with the love of my life for sixty years, and now I'm dying. We're going to Venice. We're getting in that gondola." You go in that gondola, Esme! Meredith is near tears, and smiles ruefully at the wise old woman.
We switch to a shot of Seattle at night, then to Sav and Weiss and McDreamy and Addison. Sav is telling the McDreamys that they're going to make it, because they were always meant to be. Addison looks hopeful, McDreamy like he wants to slit his wrists. Sav proposes a toast to taking life in your own hands. They all cheer. Then Weiss proposes his own special toast: "And here's to bull, and here's to crap!" HA! "And here's to oopherectomy, hysterectomy, and double bilateral mastectomy. How smart am I to know all those words?" Oh, wait, not so funny anymore. I'd like to note here that everyone stops drinking but McDreamy. My kind of man. Savvy begs Weiss to stop, but he goes on to toast breast reconstruction, nipple reconstruction, losing your wife, and also being the ass who can't be supportive. Hear, hear! Or not. Weiss gets up and leaves, ruining their super-fun time. Commercials.
The next day, Weiss is still dithering about being there for Sav's surgery. McDreamy says they can get through this. Weiss: "This is coming from a guy who packed his bags in the middle of the night and drove three thousand miles to live in a trailer." McDreamy concedes that he might have been crazy to do that, but he's probably crazier now for trying to work things out with Addison. "Am I out of my mind, man? I mean, you tell me." Weiss has no answer for this. McDreamy has some kind of epiphany, and says it's about the ring. He says Savvy didn't screw around with his best friend, and she's looking for support. And if he can't give her that...if doesn't give her that..."then what the hell am I doing?"
Mere walks out of Esme's room, and Esme's husband stops her at the door. "You didn't tell her, did you?" Meredith hesitates for a moment, then lies that she didn't. Mr. Sorrento gives her a grateful look, then goes in to check on Esme and bring her some coffee. Ben Harper plays in the background, letting us know that it is all very very poignant.
Later, Mere and George are on a roof getting all existentialist on us. George is disappointed because he thought Fall Guy had cheated fate somehow. Mere says maybe he did cheat fate. George: "He died." Point taken. Mere says she thinks you can't wait for something to fly underneath you and save your life -- you have to save yourself. She says this as if it's these are the saddest words she's ever had to say. Aw, Hello Kitty, why so glum? George: "You mean, the pigeons aren't going to come?" Meredith confirms that, no, the pigeons aren't going to come. I don't know what that means.
Cut to Savvy's hospital room. Addison is taking vaguely pornographic pictures of Sav's boobs, in an attempt to document them before they are removed from her body. Sav is like, "You know these are gonna be next year's holiday cards. And this way Weiss gets to look at them whenever he wants." Somehow, I think that is going to be cold comfort for Weiss. And probably kind of tacky for a holiday card. Addison says she'll take Sav down to the pre-op in just a few minutes. Sav says she knows Weiss will show up, because he always does. Addison gets very serious, and tells Sav that as her doctor, she's behind her 100%. "But as your friend, are you absolutely sure about this?" Sav says she gets it. She knows what she's losing, but then she thinks about what she's gaining: "My life. This gives me a shot, a shot at me and Weiss becoming this old wrinkled couple who argue all the time. Wouldn't you want that? A chance to grow old with Derek?" Addison's face breaks and she says, "Yeah. Yeah, I do." Tears! Addison has reduced me to tears, now that's something to cry about right there. Sav cries, "Oh, God!" and Addison comforts her, which is Meredith's cue to start up with her voice-over.
"Maybe Romeo and Juliet were fated to be together, but just for a while, and then their time passed. If they could have known that beforehand, maybe it all would have been okay." Alex finds Izzie in the locker room, sits down behind her, and says, "I like your rack." Awesome. Izzie jumps up, all, "What is WRONG with you?" Alex says he likes her rack, and he'd want them around if he could have them, but it wouldn't matter if you got rid of them. "Because, really? I want you." Izzie then slaps him hard across the face, I guess for the rack comment? MereVO: "I told Mrs. Snyder that when I was grown up, I'd take fate into my own hands." Izzie grabs Alex and kisses him, with tongue. Mere: "I wouldn't let some guy drag me down." Izzie gets up and walks out, a smile creeping across her face as she goes. Pretty music starts to play, by a girl with a pretty voice whose name I do not know.
Esme gets discharged from the hospital. Her husband takes her by the hand and gently leads her out. MereVO: "Mrs. Snyder said that I'd be lucky if I ever had that kind of passion with someone, and if I did, we'd be together forever." Mere sadly watches the Sorrentos leave the hospital, surely on their way to Venice and the Bridge of Sighs.
Cut to Burke and Cristina leaving the hospital. Burke says he guesses they never did get that first date. Cristina whips around and enthuses, "Are you kidding? That was the best date I've ever been on." Yay!
Sav is in the OR and prepped for surgery. Mere tells us, "Even now, I believe that for the most part, love is about choices." Sav looks around, and the door slams open, revealing...McDreamy? Oh, you know it's just a trick. Weiss follows him in, and Savvy starts to cry, saying, "You're here!" MereVO says it's about putting down the poison and the dagger and making your own happy ending...most of the time. As she says this, McDreamy and Addison exchange looks. Uh huh. Addison tells Sav they're going to go ahead and get started now. Sav says she's ready, and squeezes Weiss's hand.
MereVO: "...And sometimes, despite all your best intentions, fate wins anyway." Mere steps into the elevator, and there is McDreamy, waiting at the back. She turns around to face the front, and murmurs, "I miss you." McDreamy steps up behind her. He takes a whiff of her hair and starts to lean in -- just long enough for it to become extremely hot -- and then whispers, "I can't." The music picks up, and McDreamy exits the elevator. Whew! Somebody better end this episode before all of America falls into a swoon.