As Joe is wheeled into surgery, he gives Alex a bunch of last-minute orders about the bar. We then cut to Webber telling George he's sorry, but there's nothing they can do -- they operate on patients, then release them, and it's not their job to help them pay their bills. Aw, Joe!
Surgery. Joe has been anesthetized, and ice packs are placed on and around his body. Up in the observation room, Bailey tells George he won't be able to see anything from way back where he's sitting. George says he knows; he's trying to find some kind of a loophole to help Joe with his medical bills. Bailey says she was the only intern her first year. "I didn't know anybody, and nobody knew me except Joe. He knew me." George gets the wrong idea, all, "Oh, really? You and Joe?" Bailey says all he ever thinks about is how to get into somebody's pants, then hits him upside the head. "You nasty. That's how you got syphilis." Heeeee. Alex walks in and slags on Izzie for bringing snacks to watch Joe die. Izzie says it's just a granola bar, and it's not like Joe is going to die-die, it's just for a few minutes. George jumps up and yells, "Dead! That's it!" He runs out of the room excitedly.
Mere, meanwhile, watches Addison start surgery on the twins' mom, and looks at her like she either wants to make out with her or kill her.
Back in the OR with Joe, they've lowered his body temperature to 60 degrees. Burke announces, "Okay, Joe! Time to die." The other doctors watch anxiously as Joe flatlines. McDreamy tells them they've got forty-five minutes. The clock starts, and we go to commercial.
As the doctors operate, they tell Joe stories. McDreamy's goes like this: he went to Joe's the night before he started working at the hospital. He'd only been in town a few days, and he met this woman. "I got drunk and she took advantage of me. Or she got drunk and I took advantage of her. Well, we were drunk, definitely, and somebody took advantage. I like to look at it as my initiation into Seattle. What about you?" Burke says he doesn't actually have one -- he just wanted to make McDreamy tell his. Heh. McDreamy rolls his eyes, and they get back to work.
George is on the phone with someone about Joe. He seems to be making good progress. Up in the observation room, Alex is busy selling himself to Izzie: "I'm really a good guy if you get to know me." Izzie's like, "Uh huh. There's nothing about you that is even remotely human." This conversation is interrupted by McDreamy cursing, saying he can't get a clamp to hold. They've got seventeen minutes left, and Burke says he's going to need at least eight minutes to bring Joe back and warm him up. McDreamy remarks that he better make his last few minutes count, then. I'll say.