Derek and Meredith are broken up the best way -- with lots and lots of sex. They also agree that mockery can be part of the package, but anything else is off limits. While they're off doing the horizontal mambo (tm Derek), Izzie and George are downstairs discussing his love. Izzie looks delighted, and George is determined to tell Callie that he can't be married to her. He nearly kisses Izzie, but refrains until he can break it to his wife that he's in love with a really, really annoying other woman. He doesn't get the chance, though, because when he runs into Callie, there's a group of patients just coming in to the hospital who were injured in a gas explosion in an apartment building. Among the patients are a young couple and their one-year-old son, a friend of his who had stopped by to visit, and their neighbor Ben Vereen. While Alex is trying to care for the baby, he realizes that the child is addicted to meth and that the accident wasn't so much a gas explosion as a meth lab explosion which has seriously injured the mom. While she is in surgery, Alex tries to treat the baby while his nervous father watches (and hinders) his efforts. Unable to wait for social services, Alex confronts him about the meth, which causes Dad to punch Alex out and run away with the child. Callie, already having a hard time controlling her residents, is held responsible by an angry Chief since he told her to take care of the whole situation. At the end of her terrible, horrible, no-good, very bad day, George approaches Callie to have a Talk with her, but she begs him as his wife to not say whatever it is just yet. Because it looks like she has already guessed the horror that is Gizzie.
Meanwhile, Mama has shown up at the hospital to see Cristina, who does everything she can to avoid her, including sending Meredith out to be verbally beaten by the woman. While Mama waits, she doles out some hard truths to George and Derek as well. Cristina spends a while hiding in the clinic with Meredith and trying to keep Lexie away from her half-sister, but eventually, Lexie and Mere are alone, and Mere lays out the reasons that she's having a hard time -- namely that their father left Meredith to father Lexie, and as a result Mere can't have a functional relationship with Derek. Fair enough, really, when you hear it laid out as such. Cristina finally finds the strength to face Mama, who is there to get the key to pick up Burke's belongings, chastise Cristina, and confirm that Burke really is never coming back. But hey, at least that means she'll be able to see the floor in her apartment, again since all of the would-be wedding gifts are gone.
When last we left Grey's Anatomy, George had horrifyingly told Izzie he loved her too, and Meredith and Derek got it on in the on-call room to punctuate their breakup.
The background for Meredith's opening VO is a beautiful shot of Seattle at night. "In the hospital, we see addiction every day." It's post-"I love you too" and George is exhilarated, babbling to Izzie about how amazing he feels, and how it's just like he's woken up. Mere's voice thankfully breaks in to the disgusting reverie to add, "It's shocking how many kinds of addiction exist." She and Derek are up in her room in bed, still "breaking up," it seems. Meredith pronounces it the best breakup ever; Derek asks why they didn't do this earlier. But the giddy afterglow is dimmed when he rolls over to go to sleep and Mere freaks. Even though it's 3 AM, she orders him home, maintaining that they're just having sex since it's the only part of a relationship that works. When he jokes about messing it up with dinner and sleepovers, she mock-pouts, "You're mocking my severe emotional limitations." It's getting a little old for her to keep admitting these problems, while not actually making any effort to overcome them. In a nice little bit of continuity, he points out that he can live without sleeping over because she snores. They laugh, and he adds that mockery is a deal-breaker. Mere declares, "Okay, sex and mockery it is." Mere VO adds, "It would be too easy if it was just drugs, and booze, and cigarettes."
Downstairs, George sort of explains his marriage, explaining that Callie said she loved him, and his dad loved her, so...he drops it before he can add that he decided to take control of his future and try acting like an adult. Instead, he just stammers to Izzie, "I shouldn't have gotten married."
Cristina is in what I still want to call Burke's, but is really her, apartment, sitting in the dark surrounded completely by gifts. VO: "I think the hardest part of kicking a habit is wanting to kick it. I mean, we get addicted for a reason, right?" Cristina grabs a gift and angrily rips some paper off. After a moment she tries it again, with even more gusto, and continues ripping wrapping off of the gifts within reach. She looks more miserable than angry, despite her best efforts to take it out on the paper.
Despite my most desperate wishes, the conversation between George and Izzie goes on and on as he babbles about how he thought his marriage was right, but it isn't. Izzie agrees with him. (Well, he did certainly pick the right audience for this little realization.) Mere's voice astutely adds, "Often, too often, things that start out as just a normal part of your life at some point cross the line. To obsessive. Compulsive. Out of control." Out of control describes the level of my revulsion at seeing Izzie lean in slowly to kiss George. Thankfully, he pulls away and says that he has to tell Callie. Izzie seems confused that he doesn't want to jump her excited bones, as he leaps up and exclaims, "I have to tell her the marriage is over. It's the right thing to do." He grabs his things and leaves, but a second later opens the door back up and excitedly asks, "Did you see how I walked out of here all determined?" Izzie says it made her proud, and he leaves again. Mere wraps up her intro to explain, "It's the high we're chasing. The high that makes everything else...fade away." Izzie whispers, "He loves me too." In her case, it's any small shred of sanity, dignity, and likeability that has faded away.
At the hospital, the Chief is gazing at the surgery board while Derek blearily drinks coffee from a travel mug. Derek tells him the board looks good and Richard replies that he didn't do it, since he's delegating -- doing it for his wife. Derek's response to this show of marital faith is to ask if she's talking to him yet. He replies, "She will when she sees I'm a delegator." He then says he should move one of the surgeries, and Derek chuckles and calls him a junkie. We're going especially literal on this week's theme, I see. As he leaves, Mark comes along carrying his own coffee. Or as I like to call it, "caffeinated nectar of life." What? I don't have a problem. I can walk away at any time. Derek's putting in eye drops, and Mark guesses that he and Meredith are back together and doing the "horizontal salsa." Derek corrects him with, "Mambo! Horizontal mambo." I find it very hard to believe that a man-whore like Mark would make such a mistake. Derek then tells him that he and Mere are just friends, all the while with a sexy shit-eating grin on his face. Maybe it's just that this season is already lighter than Season Three, but I feel like McDreamy might actually earn his nickname back one of these days if things keep moving in this good-looking direction. Mark adds, "Sexy friends." He's a saucy minx. Derek tells him he's disgusting, but he's laughing so it doesn't carry much weight, and Mark tells him that the first step to recovery is admitting you have a problem. Derek just asks him how many nurses he's slept with this week. Mark responds, "That's not a problem, man, that's an adventure." If only there were men like this in my workplace. Or even men, period.