Alex is having his own difficult time holding up under the pressure and the constant second-guessing from the examiners. He finally says what procedure he'd use in a certain situation but he's wrong, and he realizes that it was a trick question. The other examiner reminds him that he had all of the facts to answer it correctly, and he just snaps. He hollers at them that he can't believe he's going to fail because of a trick question and only gets angrier when they tell him the test is designed that way. They remind him that he did, in fact, miss the first third of the test and he just yells again that he missed it for the best possible reason. Sorry, Alex, but it's true -- it's no excuse when every single one of the examiners and test-takers are all doctors and they all managed to show up. Meredith is vomiting in between answers, for goodness' sake. And then he proves that his reasons for staying were personal when he slips up and asks if he's supposed to help this baby for months and then just walk away from the mother at the end. He then adds snidely that all he missed in that first session was more hypothetical trick questions. He yells and yells and comes completely unglued when the guy mispronounces his name as closes his notebook and thereby ends the test. After all that, Alex asks them desperately if they can tell him if he passed, but they both stare at him, unmoved. He bursts out the door and then angrily throws his bag down the hall before kneeling down with his head in his hands.
Downstairs, Catherine and Richard are both heading home. Catherine tells him that she doesn't regret what they did and he agrees he feels the same, with that too-casual tone of someone who isn't entirely at ease. I think, though, that's because she's leaving and not because he regrets it happening because the next thing he does is tell her it's bad timing, they live in different cities, it would be too complicated... making excuses in that way that invites someone to try and counter them. But she doesn't, and they just say goodbye. As she is about to leave, though, he asks her if she's going to a conference at which he is speaking. Her eyes light up as she tells him she's speaking there too, and she asks where he is staying. It turns out he's in a different place than she is and she immediately tells him to change his reservation because her place has a better breakfast biscuit. And then, a beautiful friendship with benefits was born.
In Seattle, Charlie is out of surgery and examining his once-again round skull. His wife is absolutely thrilled until he asks the doctors how soon he can get back on a ladder. Libby begs Derek to talk some sense into him but Derek just smiles and says it's not his place, but she should say something if she wants to. She tells Charlie gently that she knows how much he loves working on the house, but he's clumsy and she can't stand to think of almost losing him again. This is so blatant it doesn't even deserve to be thought of as a metaphor for poor Lexie. Charlie is touched to hear how worried Libby was and it makes him realize he needs to not be climbing up to do DIY on the roof anymore. As they banter, Lexie gives things a good long think.