Mr. O'Malley's room. The family is gathered around as Bailey disconnects his breathing tube and turns off some other life support equipment. And after a few moments, George's father dies.
George emerges from his father's room, alone. Callie, Alex, and Cristina are all in the hallway, all looking incredibly sad. George slowly walks past them. Cristina looks thoughtful for a moment and then turns to follow him.
In a different corridor, we see Heather using a walker to take a few upright steps, accompanied by her mother and (I assume) a physical therapist. Izzie turns a corner and sees this, and smiles.
Izzie finds Bailey sitting on a gurney in a corridor. She sits next to her and says, "I'm both." In response to Bailey's confusion, Izzie continues, "I'm both. I'm a surgeon and I'm a person who becomes emotionally involved. I will never again cross a line like I did with Denny. I've learned my lesson. But I'm still both, and I'm not gonna give up either part of me, and I'm not gonna apologize for it." Bailey nods, and Izzie stands up and walks away. And Bailey sobs.
George is standing in front of the hospital. Cristina walks up to him in the obvious cold and tells him, "There's a club. The dead dads club, and you can't be in it until you're in it. You can try to understand, you can sympathize, but until you feel that loss... My dad died when I was nine." George nods slightly. Cristina: "George, I'm really sorry you had to join the club." George, his voice raw, tells her, "I don't know how to exist in a world where my dad doesn't." Cristina: "Yeah, that never really changes."
Joe's bar. Addison looks sad over a drink. Alex enters and orders a beer. He also is the one who has to break the news about George's dad to Joe. Addison says "hey" to Alex and he sits next to her. She asks him if he has a father, and he tells her that he doesn't really. She strokes his face, and they move in for the very, very inappropriate kiss. At this point, Izzie is the only intern who hasn't started a relationship with an attending or a resident. You are a sorry bunch of people if Izzie Stevens is the one amongst you with the best boundaries.
Meredith is sleeping on her side in her pretty red sheets. The camera pans over to the pillow next to her, on which she has left a box of wax earplugs. Derek climbs into bed and smiles when he sees the earplugs. He puts them in his ears, smiles, kisses Mere's cheek, and cuddles up with her. If he really wanted to show some appreciation for the earplugs, he might have shaved or taken a swig of mouthwash. Credits.