Richard follows Derek after he storms into the trailer and Derek starts literally screeching at him to get out and punches a wall to show how serious he is. Richard is finally acting like an adult this time, though, and says that while he's destroyed lives before ("several, in fact") Derek's is not one of them. He claims he sent the woman Derek loves to bring him back to his life and that it's all Derek to ruin things, he doesn't accept it. It's a pretty good dressing down, actually, as he says that he was drunk for years while Derek has only been drunk for days and that he knows Derek will need a friend when he comes out of the hole he's been digging. Richard will be there, and he adds that he hopes Derek comes out soon. He's finally broken through where others couldn't, and Derek lowers himself to sit on the bed and whispers that he doesn't think he can get her back. Richard asks logically if he's called, but Derek isn't sure what to say. Richard admits to Derek that he had an affair (though he doesn't mention with whom) and that Adele somehow found it in herself to take him back. "You can make your way back from anything." Derek nods as the music swells with hope.
Meredith and George are all in the bathroom with the interns, and George has taken the guys aside and actually started being helpful, telling them that this is only their first year and they won't make it if they turn on each other now. Megan then comes out of one of the stalls and hands a pregnancy test (!) to Mere. Okay, this part is slightly juicier than some of what Mere and Gang got up to last year. She orders them to never behave like this again, then sends Pierce to get an ice pack for his eye, Steve to get his hand stitched and x-rayed and Megan, "You... should... go to OB. Because yes, you are pregnant." With that punctuation, no one has anything else to say and the interns file out while George tells her admiringly, "That was very Bailey." As in most things, Bailey is the best person ever to look up to, this time in terms of dealing with soapy intern antics.
Cristina is then in her own OR and the anesthesiologist asks if she is ready. Kendall interrupts to say she needs one thing before she goes under, then proceeds to stand up for herself a bit. She says that Cristina didn't answer any of her questions and while Kendall understands that she is busy, she doesn't want to die. "I may just be a batty old lady to you and this may be a silly little procedure, but I need you to tell me that it's going to be ok. You're my surgeon, after all." Cristina's eyes say that she knows she deserves all of that and she's sorry, and she tells Kendall sincerely that it's not a silly procedure to her, and she'll get Kendall through this. Kendall is satisfied, and they put her under. Cristina stares down at the abdomen but the talking-to she just received seems to have gotten to her, and she waits a moment. She then looks up and in an even voice tells Alex and Bailey, "Izzie has stage 4 metastatic melanoma that has spread to her brain, liver and skin. She may only have months to live and she's resisting treatment." The eye acting is especially good throughout this whole scene -- Alex is totally stricken as Cristina adds that Izzie needs help, and Bailey looks like she's just been physically crushed. Having said that, Cristina is ready and asks for the scalpel to make her first cut. Alex, meanwhile, visibly reels from what he's just been told.