Meredith finds Alex updating the surgery board; she tells him that they finished Aaron's surgery and it went well, describing how it was pretty big, but Bailey fixed him all up and he'll be waking up soon if Alex wants to stop by. He finally nods -- the first sign he's heard anything she said -- and as she walks off to let him digest the news he turns and watches her go.
Mr. Clark is sitting across from Derek in his office while Richard stands to the side, and April and Lexie are back in the corner watching the horrible conversation. When Derek tells Mr. Clark how sorry he is for the man's loss, Mr. Clark orders him not to talk about his wife like she's already dead. He again voices hope that she could wake up, and firmly Derek tells him that she won't. When they talk about her signed directive her husband again argues that it was something she signed three years earlier, so Derek describes how her health will deteriorate, and Richard adds how expensive it will be. Mr. Clark doesn't care, nor does he want Derek suggesting that he has any idea what Mrs. Clark might have been thinking about not wanting either her or her husband to have that kind of life. Derek is actually hitting a perfect balance between sympathetic and firm, one I feel he hasn't been able to quite achieve before this -- his scales always tend to tilt towards "pompous." But he finally tells Mr. Clark that the ethics board reviewed the case and decided that the hospital has to obey the directive. Mr. Clark accuses them of killing her by unplugging the machine, but Derek just stays calm and tells the man to take all the time he needs to call the family and say goodbye. That's what tips Mr. Clark's own scale, and he slumps and tells them that there isn't anyone to call because it was just the two of them, and they never had any kids. Wow, that was subtle. Derek just looks sad, and April is staring at him with lovesick eyes again but this time she realizes that Lexie has caught her. She runs out of the office but Lexie is on her heels.
Out in the hall she yells at April that Derek is her sister's husband, and April tries to act confused but Lexie orders her not to play stupid. April drops the guise immediately and whines that she isn't playing, she really is stupid as well as humiliated. She cries that she's never felt like this before, and then begs Lexie to forget what she saw and go back to the way things were, promising that she'll never see anything like that again. April begs, and finally Lexie just turns and storms down the hall, yelling, "This day sucks! I hate this day!" I feel for her, but it's also kind of awesome because it so embodies just how I feel when you have one of those hopeless, terrible, everything-that-can-does-go-wrong kind of days and there's nothing left to do but stamp your foot.