Addison, Mark, and Alex rush out of what I'm assuming is Crush's O.R. Addison is furious that Mark wouldn't wait for the surgery, but he points out that she had already lost 40% of the vision in her right eye and would have lost what was left within a day. Addison thinks that's not true and that he was just trying to impress Marlowe. They're screaming at each other by this point. One thing we learn during the argument is that Crush and her baby are both fine. Alex is watching all of this with some interest, but Addison yells at him to go stay with Crush. And then Derek walks up and asks what happened. They continue arguing in front of him. At one point he agrees with Addison, so Mark tells him, "You're not her husband. This isn't your patient. Stay out of it!" And then the Chief walks up and starts screaming at them for screaming in front of everyone. They all walk off in different directions.
And now it's Helen's surgery. Derek is futzing around with her brain while Marlowe talks about what a difficult surgery it is. And then there's some beeping and it looks like Helen is having a stroke or some kind of cardiac event. Everyone rushes around in a panic.
In another O.R., the Chief, Callie, and Izzie are taking the bullet out of G.O.M.'s shoulder. The Chief pulls the bullet out and tells a nurse to make sure the patient gets it. Izzie thinks that's a little warped, but Callie tells her, "I get it. If they pulled a bullet out of me, I'd want it cast in gold and mounted on my wall." Izzie: "Yeah, well you can afford it." Callie realizes immediately that George must have said something to Izzie. Izzie catches her eye and realizes she just made a huge mistake.
Back in Helen's O.R., it's still very beepy and panicky. Whatever Derek did to her brain isn't working, so he moves to her side for some kind of heart procedure. Marlowe points out that he's a cardio surgeon and is probably better suited for whatever is going to be done, but Derek points out that Marlowe doesn't have any operating privileges at Seattle Grace. And let's all take a moment to commemorate the first time someone in this hospital actually followed the rules. I'd also like to point out that even though Marlowe doesn't have privileges at Seattle Grace, he is apparently traveling with a pair of sexy black scrubs. Someone offers to page Burke, but Derek tells them he's got it. And then he cuts a hole in Helen's torso and has George reach in and massage her heart. And then her heart starts to beat on its own. Derek walks away from the table and takes a breath. George asks if he should start closing up Helen's incision. Derek: "O'Malley, I just sliced my friend's chest open. Give me a moment."