It seems that Dave did call his friends but he's talking to Izzie, wondering why they would come back after what he said. Izzie tries to assure him that he was scared and just trying to protect them, like she is idiotically trying to do herself. Well, except that last part I added in since she didn't actually offer it up. She assures him that if they are his friends, they'll understand, as Lexie walks in with all three of them behind her. He turns and looks straight at them, admitting that he didn't want them to see him like this -- that the ugliness isn't him. Sheena walks up and says that he looks just like the nameofhisorchidicantfigureout, asking if the others see it. They chime in that the coloring is just the same but a very emotional Dave interrupts to say that if the surgery doesn't take he'll be even uglier than he is now. Sheena makes me reach for the Kleenex again as she tells him gently, "Please don't call my dear friend ugly. You're a survivor. And it's written all over your face." With that she leans in and kisses him while Izzie tries not to cry as she watches.
The pity party is still in full slump when the Chief arrives and demands to know what's going on -- Callie, at least, has the good grace to sit up straighter like a student who has just been reprimanded. He yells at Derek that they've all been there, but Callie points out that they already said that. Richard tries pointing out that they've all had tough losses, and that they then show up the next day to try and save another life. Hunt and Callie point out that they tried saying that too, so Richard tries another tack. He reminds them that there is nothing they can do to stop death, they can only hold it at bay but eventually everyone dies. "And that's not on us." Angry that his moping has been interrupted, Derek reminds him that he botched a simple surgery on a pregnant woman and that he should feel bad about it. He then adds that Richard should feel bad for sending Meredith to him expecting a ring. When the Chief lamely says he was trying to help, especially since Meredith wanted to just leave Derek alone, Derek yells that he was trying to help himself. I hate to say it, but he's not entirely wrong. However, when Derek then says he hit the ring into the woods (well, grass, but who's counting) and growls, "You destroyed me," it's a little bit much. I think I'd have to choose Condescending Derek over Self-Pity Derek in "Death is Not an Option."
His friends in place, David has gone into surgery and it's time to put on his new face. In front of a huge crowd of doctors, Mark asks Lexie if she wants to do the honors with him; they both take a side of the face and he talks her through placing it onto David. He then compliments her work and they hear a laugh through the glass where the interns are doing a loving reenactment of what just happens. Lexie looks down, uncomfortable.