Addison is meanwhile in Richard's office, explaining why she's going to leave Seattle. He says he's not accepting her resignation, but she points out it's not a resignation since she doesn't actually work for him. I know that she and Derek were married for a long time and that they were close with Richard and Adele, but I never got the fever with which they wanted the two Shepherds to get back together. Addison cheated on Derek, and Derek loathes her, which to me seems like a good recipe to work on moving on with one's life rather than to try and fix something that seems irreparably broken. But again, good TV. And don't get me wrong, I love Addison on the show. I guess this means I should shut my yap with all this nitpicking and be glad they kept her in the cast. She sadly reminds Richard that Derek calls her Satan, but Richard tells her she never hides from a fight. She says she's leaving in the morning, and at that moment George walks in and tells Richard that it's about Ellis.
It turns out that in addition to her diverticulitis (seriously, try typing that quickly; oy), they found a mass in her liver. George is already sad for Meredith that she has to deal with Ellis's cancer on top of everything else, but Richard reminds him they don't know for sure that it's cancer until they do a biopsy. Addison has been following them down the hall when Izzie catches up with her. Addie tries to say no to a new patient until Izzie throws her cards on the table and admits that it's Cristina who has collapsed. George is worried, and also confused that she'd be asking Addison for help. After yet another Meaningful Glance, this time from Izzie, they all realize why. George, ever the model of restraint and discretion, exclaims, "Cristina's pregnant?!" Addison rushes off behind Izzie, calling over her shoulder that she's still leaving in the morning; the Chief takes off his hat and rubs his head; and George declares, "This is a very bad day."
Meredith and Alex are both in surgery with Mr. Dr. Shepherd. Richard comes in and without pretense demands that he be cleared for surgery, and that all he needs is a verbal okay. Derek won't do it, despite Richard declaring that he's the Chief and this is not a request. Derek points out that in this situation, it's his call, as he's Richard's doctor and Richard isn't ready. The Chief sends a Meaningful Glance in Mere's direction and says more quietly that it's a simple procedure. George is waiting in the doorway the whole time; wouldn't that have been a giveaway to Meredith already that this concerned her mother? Richard argues to do a simple biopsy, and Derek wonders what he's missing as to why a resident can't do it. Richard can't not look at Meredith guiltily, and she guesses that it's about her mom, asking if he thinks she has cancer. Richard just tells her that George needs her signature. Derek sympathetically but sternly says he knows Ellis is a friend, but that he's not clearing Richard for surgery.