Mere and Dere are still elbows-deep in Walker's spine, and they've yet to find anything. Mere thinks that maybe Walker just injured his spinal cord and there's nothing to fix. Derek chides Meredith for depending too much on her books, but before she can deliver a tasty retort, Walker's pressure starts going up. Mere asks what's going on and all I can make out is that Walker's BP is wonky and that it has to do with potential nerve damage. Mere's concerned. Derek says they have to get the blood clot out, dammit! He tells Mere to keep on the bleeders and keep looking for the clot.
George is shuffling down a hallway when the pretty redheaded nurse comes out and tells him that her patient's pulse oxygen is dropping and she needs to be intubated. "Isn't...there...anyone else who can do this?" asks George. Red is all, uh, dude? You're standing right here. Grab your nuts in one hand and intubate my damn patient with the other! In an effort to impress the girl, George smoothly and quickly intubates the patient as Burke just happens to pass by the window. "Smooth moves, doctor," says the nurse. "Kicked ass," smurfs George. Burke watches all of this and seems to consider something.
Later that day, Alex is coming down some stairs as Burke is coming up. Burke nonchalantly asks how quickly he can get a cow valve, and Alex says it'd take about sixty minutes by messenger. "You're scrubbing in," says Burke. Alex thanks him profusely. "This doesn't get you any points, Karev. I'm the only one with points around here, okay?" Alex nods in agreement and starts to leave. "Oh, by the way, Karev," says Burke. "Devo wants a rabbi to bless her before her surgery." "Seriously?" "You came up with the cow, you can find that girl a rabbi." Heh.
Checking in with Walker's back, Derek suddenly spies something on the third thoracic vertebrae. Mere sees it too. I guess it's the clot they've been looking for. Mere can't believe it's there. Derek acts like he knew it was there all along. Smug bastard. After the surgery, Mere and Dere exit the OR and she asks if Walker's going to be okay. Derek thinks so. Mere's all, but you don't know for sure. Derek says he knows that they stopped the paralysis from advancing. Mere says he doesn't know if the paralysis that's already occurred will be permanent. Derek agrees that he doesn't know that. "You know, you keep taking everything on faith," she says as they wash their hands. "How do you know what's real and what's not?" "You just do," he says. "Oh, and you stop ASKING SO MANY FREAKING QUESTIONS." Mere just looks at him and Derek says, "You know, some people would call this a relationship. The kind where you exchange keys, leave your toothbrush over." "Who?" she asks. "Who would call it that?" "Me. I would." "And I'm supposed to believe you." "Uh-huh." "Show me something. Give me a reason to believe." He just looks at her and then walks away. GOD.