We pick things up the next morning, and when Izzie wakes up from her surgery, she knows who she and everyone else is, and Derek got the entire tumor. Yay! Except that then she asks again if they got the tumor, they did, yay! But did they get the tumor... you get the very repetitive picture. Alex becomes a drill sergeant of sorts -- he puts notes up around the room with answers to all of the questions she keeps asking and keeps drilling her and drilling her on the answers. Cristina tries to get him to take it easy but he refuses, and finally Izzie tells him to just say what he really wants to since she won't remember it anyway. So he does, and he winds up yelling about how he got suckered into getting married and now he's going to have to be her babysitter and he wants to smother her with a pillow, that kind of charming talk. Good old Alex.
Bailey is offered the pediatric fellowship but doesn't immediately accept and when Arizona tells her how prestigious it is, Bailey finally admits that Tucker gave her an ultimatum -- become an Attending in general surgery or he's going to divorce her. She goes to the Chief to ask if the offer is still open and while I don't think he ever really answers her, she admits the whole ultimatum to him. It turns out she's going to leave him anyway because she wisely thinks a marriage based on an ultimatum is a bad idea but if she's going to be a single parents she thinks she needs to take the job with the more regular hours. So we'll see what exactly happens with that next season.
Meredith and Derek try to make it to the courthouse to get married, but between Izzie and a John Doe patient who was hit by a bus it's too busy. Meredith kind of freaks out about it because she knows it will always be too busy but she wants to be married, so she and Derek have a private little ceremony in the locker room where they make up their own vows and write them on a post-it that they both sign. I have to admit, it's pretty sweet. Cristina, meanwhile, admits to Hunt that she loves him but she is still too freaked out to give it another go -- that is, until she talks to Meredith and realizes that therapy really did help and that Meredith really is okay now. Hunt had begged Cristina to just meet him halfway and they would muddle through together, and so she finally agrees and they have a big awesome kiss in the lobby. Oh, and as long as we're talking couples, Lexie and Mark are having a bit of weirdness after the moving in together talk but it seems like they're going to wind up being just fine.
And then we have George. The first person he tells about the Army is Bailey, and she reacts as he expected -- demanding to know what the hell he's thinking. She confronts Hunt about it while he, Mark, Derek, Meredith, Callie and Lexie are all working on a John Doe who pushed a woman out of the way of a bus to save her life. He's basically mincemeat, but they manage to keep him alive while all freaking out about the George news, since no one but Hunt seems to think it's a good idea or that he'll be okay. Callie and Bailey decide to stage an intervention at the end of the day when George is out of surgery, which causes a huge fight between Arizona and Callie since Arizona thinks what he's done is awesome. They finally have a showdown in which Arizona admits that her brother was killed in Iraq and so yeah, she thinks that George going over there to take care of everyone is awesome, and Callie seems to maybe realize she's been overreacting a tad. The girl who John pushed out of the way has stayed to hold his hand, since she feels guilty for brushing him off when he said hi to her right before The Incident. Mere also does some hand-holding and he tries to write on her palm but doesn't have the strength. At the end of the day Bailey and Callie are told by Richard that George never scrubbed in -- he sent George home to spend his last day as a civilian with his mother. And that happens just as John finally manages to write something on Meredith's hand that she can interpret: 007. John Doe is George. They rush him into his next surgery but things seem to not be going so well.
Back upstairs, Izzie is still stewing over what Alex said to her, and she tells Cristina all about it in a huff. Cristina realizes that she's not using any of her notes, and that her memory really is coming back. Cristina finds Alex and he and Izzie rejoice; he tells her he didn't mean any of what he said, but she knew that already. As he holds her in a big bear hug, she goes limp. Because of the DNR, they let her go but Alex does compressions and begs Cristina, Bailey and Richard to help him and Richard finally disregards the DNR and they launch into full life-saving mode. As they shock her chest and we see her flatline, and George's vitals go bad, we fade in to a scene of Izzie, all dolled up for prom, getting in the elevator. When the doors re-open, there is George, hair shorn and in an Army dress uniform, waiting for her. She looks conflicted, and we fade out on the season not knowing if she and George are in fact going to go, hand-in-hand, to The Other Side.
Hot on the heels of Hour 1, Hour 2 is ushered in a few minutes before 10pm, but gets its own spanking-new voiceover. "Doctors spend a lot of time focused on the future. Planning it. Working toward it." Alex, George, Meredith and Cristina are all sleeping in chairs in Izzie's hospital room. "But at some point you start to realize your life is happening now. Not after med school, not after residency, right now. Blink and you'll miss it. Bailey comes in and notes that they all look like crap, and all but Izzie get up and get ready to go. Bailey gets a page from the Chief as George runs out to get ready for a surgery with him; he asks Mere to give him a status update later. Meredith and Cristina turn to leave but Alex growls that Derek said Izzie would wake up in the morning and demands angrily to know what Derek told Mere. I don't think I could have imagined Alex more on edge than we've ever seen him, but here it is. Mere tells him that Derek said it might be a while and leaves, and Cristina puts a hand on Alex's back and tries to assure him that Izzie will wake up. Lo and behold, Izzie has a bandage on her head where Derek operated, and that combined with her not having hair makes her actually look like a realistic post-brain-surgery patient, possibly the most realistic one this show has ever given us.
Out in the hall, Cristina puts on her lab coat and sees George and Hunt through the door. They shake hands and then do a textbook, back-clapping man-hug as she watches, curious.
Bailey drags herself into the Chief's office, looking just as hellish as her residents. She reports that Izzie isn't awake and adds that she's having a bad day independent of all that as well, so don't take her face personally. Arizona then bounces in and asks if the Chief told her -- he didn't, Arizona should, and she shouldn't take Bailey's face personally. Arizona then happily welcomes Bailey to the fellowship program in peds, and announces that they are getting her a pair of wheelie sneakers. Now THAT I'd like to see. And yet I'm certain I never will. Bailey's stone expression doesn't change, so Richard gets up to congratulate her and acknowledges that while he didn't support her before, he's totally behind her now. When she just glares, he gets annoyed and asks/orders her to meet him halfway since he is trying to be a big person. Bailey just glares at him and walks out without a word, much to his and Arizona's confusion.