Dory and her quintuplets are still in the hospital (it's actually the next day following last week's episode), and only one of them is doing well. Dory, understandably, gets hit with a five-time whammy of hormones and depression, and feels like her babies' health problems are all her fault. Izzie does her best to juggle: 1) taking care of the babies, 2) being real mad at Alex, and 3) getting in a fight with Meredith for talking to Alex. She finally loses her shit when Addison teaches her a "lesson," which is not so much a lesson as leaving her alone all night to "save" a baby who is totally going to die. Thanks, Addie! Fortunately, Meredith takes Izzie to buy a dog, and the dog is adorable, so everything is all better.
Cristina gets assigned to a prisoner, played with much gnawing of scenery by Rosanna Arquette, who has swallowed several razor blades in an attempt to get out of solitary for a while. When that doesn't work, she swallows a broken light bulb, and wins Cristina's heart in the process. It's really weird. Even weirder? George, poor George, who spends the entire episode putting leeches on an old man's nose and fighting with Nurse Olivia of the Syph.
Mere starts her voice-over as we fly over Seattle at night. She says that forty years ago, the Beatles asked the world a question: they wanted to know where all the lonely people came from. As we fade into an outside shot of the hospital, then into the NICU, Mere says her theory is that a great many of the lonely people come from hospitals. "More precisely, the surgical wing of hospitals."
In the NICU, George proclaims that his quint, Lucy, is the best one. "She just smiled at me!" Izzie wearily reminds George that she's nine hours old. George insists that of the five babies, Lucy is clearly the best. The rest of Fool and the Gang are parked in front of their own incubators, and Mere says her quint Charlotte is already so smart, she's got wrinkles on her forehead. If that's a sign of intelligence, I must be a freaking genius. Izzie looks over at Mere: "A, this is not a competition. And B? My quint kicks your quints' asses." Cristina points out that Julie has her organs on the outside of her body, and she's still alive, thank you very much. Alex interrupts this amusing scene to boast about his quint, Kate, then try talking to Izzie, who tells him he's way too busy screwing nurses to talk. "Get out." Alex asks if someone will just make sure Kate's vitals remain stable. Mere says she will, which earns her a dirty look from Izzie, who then says, "I am so glad I never slept with him, which is his loss, because I'm really good in bed. Mind-blowing. Mind. Blowingly. Good in bed." Cristina asks if she's trying to seduce them, but Izzie just goes on freaking about how she can't believe he slept with Olivia instead of her. George is like, "Hey. I slept with Olivia." Izzie: "Well, then you both have bad taste." Damn. George doesn't know why she's even surprised; she knows how Alex is. Mere tells Izzie she dodged a bullet, and is better off without him. Cristina wonders why she's even surprised, since if you sleep with a snake, you get bit. Izzie thanks them for their "support." Bailey walks in and asks who's on call; Izzie says she is. Bailey tells the rest of them to go home and get some sleep -- all five quints are still alive, so it's been a good day. Mere takes this opportunity to finish her VO: "As surgeons, we ignore our own needs so we can meet our patients' needs. We ignore our friends and families so we can save other people's friends and families. Which means that, at the end of the day, all we really have is ourselves." Over shots of each Fool sleeping or sitting sadly alone, Mere says, "And nothing in this world can make you feel more alone than that."
The next morning, a hurried Cristina runs around Burke's house trying to get out the door. Burke, sitting placidly at his kitchen table reading the paper, tells her he made breakfast. Cristina just stares at him as if he's speaking a foreign language. "I don't have time for breakfast! I've got to round before anyone else if I want to get the good cases!" Burke offers his freaky girlfriend coffee instead, which she takes and pours into a go-cup. She runs out the door before Burke can even say goodbye. Ungrateful!
Mere and George are walking through the hospital making plans for the evening when they come upon McDreamy and Addison, arguing about moving out of McDreamy's trailer and into a regular-people house. Mere shushes George and follows them so she can totally eavesdrop. Addison says she didn't give up a Central Park brownstone to come live in the woods. Oh, poor Addie with her dreamy husband and million-dollar job and total inability to build an enormous house in the beautiful forest. Mere finally stops following them and turns to George: "Oh, I'm sorry. What were you saying?" George says it's nothing, and stomps into the locker room. Cristina, who is dumb, is eating some kind of snack in a bag and complaining about the lack of breakfast items in the hospital. She says sometimes she thinks we'd be better off as dogs. Mere tells her she's preaching to the choir; she's over men. George gets all offended: "A dog is not a replacement for a human being!" Oh, George, that didn't even make any sense. Alex tells the gang they better wake Izzie, who's been passed out on the floor, this whole time, because Bailey will kill her if she catches her sleeping. Cristina calls Izzie's name, then when that doesn't work, kicks her in the shoulder. Lord, Cristina! Izzie wakes up all mad. Cristina: "Hell hath no fury like a woman whose non-boyfriend screws a nurse." Hee. Izzie calls Cristina a bitch, and Cristina says she likes Izzie bitter and pissed-off, because she's almost like a normal person now.
Bailey leads rounds; they go into their first patient's room and Bailey asks George what they've got. George introduces the patient, a rugged-looking middle-aged man who has had reconstructive surgery for multiple melanomas on his nose, ear, and finger, only now blood is pooling in those sites and they're all purple and swollen and icky-looking. Bailey asks George what they need to do to get "Carl"'s blood moving again, and George suggests a "bio-therapeutic agent," which, as Carl soon learns, means they're going to put leeches on his face. Yum! Carl is completely cool with this, all, "Leeches. Huh. You don't say." Aw, I love Carl already. Bailey explains that the leeches secrete blood thinners and act sort of like a big drain for all the pooled blood, but if this makes him uncomfortable... Carl says no way, he's been a hiker for forty years, and Mother Nature hasn't come up with anything yet he hasn't found a reason to love. Bailey laughs adorably, and comments, "Big outdoorsman?" Carl: "How you think I got all these melanomas in the first place?" Oh, Carl! It's called sunblock. Learn it, live it, love it.
Next up is Annoying Pituitary Cyst Man from last week, the one Alex accidentally put into a coma. McDreamy is already there checking on him. Mere explains that APCM collapsed and hit his head, which causes McDreamy to interrupt, "That WAS the problem," and look pointedly at Alex. Alex looks nervous. Mere goes on to say that APCM was supposed to have surgery, but it was postponed when... "When I told the nurse," Alex starts to say, and is interrupted by Izzie, who snarls, "OLIVIA." Way to be professional, Iz. Alex goes on to say that he told the nurse to administer an incorrect dosage of saline. McDreamy: "Essentially dehydrating Mr. Martin's brain." Alex says there's still a chance he'll wake up and be fine. McDreamy starts to walk out angrily, but Alex stops him, says he knows he screwed up, but to please put him back on the case. McDreamy says there's nothing they can do at this point, but if he wants back on, fine. Alex takes the chart and goes over to stare really hard at APCM, as if that will wake him up. Haven't y'all heard of Blue Steel therapy?
Back in the NICU, the Quint Parents are looking sadly at all their sick little babies. Bailey leads the interns in, and Addison asks Cristina to give the parents an update. Cristina, in typical fashion, starts throwing around all kinds of medical jargon at them until Bailey interrupts her. "Uh, Yang, how 'bout we do this in plain English?" Heh. Cristina starts over and explains that Julie's surgery went well; they pushed in as much of her organ sac as possible, and think they can get the rest with a second operation. Quint Mom, whose name is Dory, is shocked that Julie has to have a second operation. Cristina's like, "Yep!" until Bailey gives her a look, then amends her statement to the much gentler, "Not for a few days." George reports on Lucy -- they put in a brain shunt, and she's doing very well. Izzie tells Dory, who's looking more and more horrified with each report, that Dr. Burke operated on Emily's atrial septum last night, and today they're going to go in and try to reconstruct the lower chamber of her heart. Mere says Charlotte's lungs were a little more underdeveloped than they would have li