Callie's father is in town to visit, and he's none too happy to learn that his daughter is now a lesbian. After a whole lot of ranting and arguing in Spanish, he ultimately cuts off Callie's trust fund since she won't quit her job and move home. It makes for a full day for Arizona, who is also dealing with a father who can't face that his 6-year-old daughter is going to die. Bailey has come in on her day off to create more strife in her marriage... I mean, to come see some sort of procedure that Arizona is doing. What she winds up doing, however, is cradling the dying child while her father desperately tries to get her to Mexico for some experimental surgery. She finally manages to convince the dad to do the right thing and be there for his little girl when she dies, but this is after an entire day of choosing to be away from her own baby. I can't help but feel that this isn't going to go well for her, especially with her admitting to Arizona that she hasn't yet told Tucker that she's changing her specialty. Keeping secrets is always good for a marriage on the brink, right?
Mark and Derek are still fighting, but they are forced to work together on a surgery and both get through it acting as ridiculous and immature as possible. Meredith tries to yell at them to make up but that doesn't work -- it takes Mark saving the patient's life with some crazy speedy surgical move to impress Derek enough to forgive his best friend. Despite their men fighting and a dumb storyline involving Lexie eating too much because of all of the tension (and conveniently timed to Chyler Leigh's real-life pregnancy weight gain) Mere and Lexie are getting along, and there's a really sweet moment between the sisters when Mere tells Lexie that she's going to be a bridesmaid in the wedding.
Ah, the wedding -- even though Meredith isn't a big-wedding type of girl, she's let Izzie take over the planning to take her mind off the whole cancer thing. She should have known better, because a big white wedding is just what Izzie has in mind. She uses her cancer to convince a vendor to leave a bunch of gowns for Mere to try on, which Mere does all the while hating every one of them. Izzie plays a couple of tasteless pranks along the way pretending that she's dying, but ultimately it turns out that the chemo she is getting knocks her on her ass and she has to admit that she's really, truly sick. Of course at the same time, Meredith finds a dress she seems to actually like and she, Izzie and Cristina have a moment of zen together.
Alex and George also have their own moment, but it takes a while to get there. Owen puts Alex in charge of the pit, and George is pretty pissed to have to report to his nemesis. A patient is brought in who seems potentially suicidal but Alex brushes this off and only grudgingly allows George to call a psych consult. Owen, who put Alex in charge in the first place, is a little bit distracted himself since he's started therapy with Dr. Amy on account of his trying to choke Cristina. It turns out the patient is in fact suicidal, and he proves it by running off and then throwing himself out of one of the hospital windows, interrupting a fight between Alex and George about who hates who more. Owen is impressed by George's ability to stay calm and think a bunch of steps ahead to help the guy, and it looks like a mentorship is born. Alex finds George at Joe's afterward, and admits that he's no good under pressure, which is an exceptionally bad thing right now given everything that Izzie is going through. They seem to come to an understanding over Guinness, though, since Guinness is the universal healer.
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We fade in on a scene that I honestly never thought I would ever see -- Meredith, looking genuinely happy while she examines her engagement ring. "Defeat isn't an option. Not for surgeons. We don't back away from the table 'til the last breath's long gone." While Derek sleeps next to her, she continues to hold up her ring and gaze at it.
"Terminal is a challenge. Life-threatening is what gets us out of bed in the morning." Izzie is in a chair getting a chemo treatment and reading a bridal magazine, while Alex sits next to her, clearly uncomfortable but acting supportive nonetheless. He looks around, however, to see a bunch of very sick-looking people in other chairs in the unit. They're arranged in a circle like any moment, someone is going to get up and start tapping everyone on the head in a bizarre game of duck-duck-goose, but no one seems to be paying attention to anyone else.
"We're not easily intimidated. We don't flinch, we don't back down," Callie and Arizona run into each other in the stairwell and after some saucy smiling, grab each other in a kiss -- so I guess that relationship is going well, then.
"And we certainly don't surrender." Cristina is in the elevator and when the doors open, she looks out to see Hunt. When he looks up and sees her she averts her eyes and starts jabbing at a button so the door will close on his tortured face. "Not at work, anyway."
Derek has woken up and he and Mere are cuddling when she asks him if he minds that she doesn't want to actually wear the ring, adding (as if it's taking every ounce of strength she has) that she'll wear it if he wants her to. But showing that miraculously he does finally know the woman he's going to marry, Derek tells her he doesn't want her to, since she's not a ring kind of bride. That said, I feel like I could see her wearing it around her neck or something, not like Carrie Bradshaw when Carrie just didn't want to be engaged, but as a quirky-Meredith thing since she is clearly finally in love and as comfortable with her life as we've seen her. But alas, I just write the recaps, not the actual episodes. Mere turns to Derek and admits that she's also not a big white-dress, church-wedding kind of bride. Derek knows this too, and suggests they get married naked in a field, but Mere also draws the line at being a naked bride. When he suggests scrubs, she laughs that it would be more her speed. They get up to get ready for work, and she finally puts the ring down -- dropping it casually onto her nightstand. Mere tells Derek that she's letting Izzie help with the wedding to take her mind off the cancer, and that she'll tell her about the theme they've clearly decided upon: simplicity. She's never met Izzie, apparently.