Mere has ventured out to the woods, and it seems that Callie and Hunt have finally sobered up and left. She's tentative, but Derek smiles and thanks her for coming. She thanks him for calling, and he tells her he loves her. She knows. Derek then asks her if she'd still love him if he wasn't a surgeon -- when she tells him no, he tries to take it like a man as she walks over and sits down next to him with a bag of things. She then explains herself so she doesn't seem quite so cold-hearted, "No, because Izzie has skin cancer that's spread to her brain." Derek drops his head as Meredith explains that he's one of only 20 people in the world who could save her. "And I don't know if I could respect somebody that could walk away from a gift like that." Surprisingly well said, Mere! She asks him to then not walk away and pulls out the scans, admitting that the situation is pretty bad. They look at each other a moment and she seems to maybe lean in just a hair, but then she turns her back and goes to her car with one look back at him.
She then VO's: "Practicing medicine doesn't lend itself well to the making of friends." Izzie takes off her badge as Bailey, Alex and then Richard watch her from the doorway. Alex drops his head -- it's clear that his heart is totally broken to bits. "Maybe because life and mortality are in our faces all the time. Maybe because in staring down death every day, we're forced to know that life, every minute, is borrowed time."
While we don't hear what she says, we see Bailey tell George the news and he turns and starts to run towards his friend as she drops her head in anguish. Back at the trailer, Derek sits with his head in his hands. After a moment, though, he picks up the scans as Meredith goes on: "And each person we let ourselves care about is just one more loss somewhere down the line.
"For this reason, I know some doctors who just don't bother making friends at all. But the rest of us? We make it our job to move the line. To push each loss as far away as we can." Back at the hospital, Meredith ties Izzie's hospital gown while Alex puts on her bracelet and Cristina listens to her heart and gives a small smile. George runs in and he and Izzie have a Best Friends Moment before he smiles at her through his own tears. She gets into bed with the help of her friends and Cristina takes her wrist ostensibly to take her pulse, though it looks like it's her own way of once again giving Izzie a friendly touch. Izzie then sits forward and starts to talk as the others gather around. And while I seriously thought I was numb to any story involving Izzie Stevens, I just added the last bit to the tissue sculpture that's going on my coffee table, because that was seriously some well done heartstring-tugging right there.