Cristina and Burke scrub in while Pierce is prepped for surgery. She asks him how they should proceed. He tells her to stand on his right side and that if he starts to tremor, he will give her a signal and she can step in to do the stitches. Cristina is worried that a scrub nurse will notice the tremor, but Burke thinks he has no choice, since Pierce will die without immediate surgery.
In the O.R., Burke gowns up, takes his position by the patient, and asks for a scalpel. And then there is cutting and it's all very tense.
Back in Di's room, Addison is telling her that as soon as they know anything about Pierce, they'll pass the info on. Addison also reminds her that she is now sans IUD and should find some other method of birth control. But Di thinks she won't be having much sex in the immediate future once she tells her current husband about the sleeping with the ex. Addison is clearly confused as to why someone who's gotten away with it would come clean about the adultery. Although it's not like it's really a well-kept secret, what with her daughter having caught them. Di tells Addison that the first time she slept with Pierce (post-divorce) she felt incredibly guilty, but as time wore on she stopped feeling any guilt. And she thinks the truth has to come out. I don't quite see the connection between the lack of guilty feelings and the need for truth-telling, but Addison is clearly moved by these words of wisdom.
O.R. Burke is clearly having a touch of difficulty, but he hasn't given Cristina the signal to step in. But she doesn't let that stop her, telling him, "Dr. Burke, I know it's a lot to ask, but I would really appreciate if you'd let me try my running whip stitch." Nobody seems too freaked out by this suggestion, and Burke lets Cristina take over as he talks her through the procedure. Up in the galley the other interns are in awe. Alex thinks Cristina is benefiting from the sexual favors she provides to Burke. George: "This sucks! Cristina gets sex and perks." Mere thinks that if George apologizes to Callie he might get the sex and the perks himself, but he doesn't really want relationship advice from Meredith. Point well taken. While the others squabble, Izzie just continues to be in awe.
Bailey enters Mrs. Niles's room. Mrs. Niles is alone and tells Bailey she doesn't really want to speak. Bailey sits down anyway and tells Mrs. Niles that when she drives home at night, she only wants to see her little baby. Mrs. Niles: "If this is where you tell me to fight the cancer so I don't miss out on the joys of motherhood..." Bailey keeps going, telling Mrs. Niles that when she gets home to the reality of a crying baby, she resents the presence of the very loud baby in her previously very quiet house. Mrs. Niles wants to know why Bailey is telling her about this, and Bailey tells her that she ends up taking out her resentment on her husband, the neighbors, the squirrels in the yard, and sometimes on the baby. And then Bailey notes that it's perfectly natural for Mrs. Niles to blame the baby and the breast feeding for the fact that she didn't catch the cancer earlier. This clearly hits the mark with Mrs. Niles, who thinks that she's a horrible mother for blaming her baby for her cancer. And then Mrs. Niles wonders if it wouldn't be better for her to die while the baby is still young so he doesn't have to go through the pain of losing her. Bailey: "And this is the part where I tell you to fight the cancer so you don't miss out on the joys of motherhood."