As the girls walk up the stairs, Cristina wonders out loud how Owen could possibly not tell her about being Chief. Mere starts to delicately ask a question but Cristina tackles it head-on and just asks if it's because she didn't have his baby. As they discuss it they run into Owen, and he and Cristina have the most awkward-polite conversation one can imagine. Like they met at a wedding and spent the night together and run into each other at the hotel check-out desk the next day bad. There's lots of stammering and over-loud laughing and assuring each other everything is okay as Owen says that he wanted to tell her, but she was asleep when she got home... we've all been here, which makes it actually all the more painful to watch. They wish each other good luck -- she with her valve replacement and he with being the boss, and then talk about celebrating. She can't do dinner because she has a long surgery, so they settle on performing an awkward hug-dance and then he leaves. Mere assures Cristina that that was pitiful.
Alex tells April that he need an assistant for his bowel resection and when she tells him good luck, he points out that he thinks it is her job to find one for him. Their fighting is broken up by Arizona, who rolls in to give Alex crap about turning down one of her surgeries. She thinks that Alex is picking a boring, easy surgery to get an easy A but warns him that he could lowball himself out of the pediatrics fellowship. It sounds like this idea never even occurred to April and she asks if it's true or if he's just trying to win the bet. Honey, that bet was made after he already had this surgery. She's trying SO hard and is SO uptight that she's almost as painful to watch as Cristina and Owen. At least he's eye candy... Regardless, when the Chief walks up and hears that Alex doesn't have an assistant yet he frets since this is one of his old patients whom he loves, and April assures him that she'll find someone even if she has to assist Alex herself. This is followed with a very weak, slightly maniacal laugh that I think the Chief deliberately ignores.
Mere is in with her patient and explains the surgery procedure to him and his wife; she'll be using a clip to stop the blood supply and then later using a needle to stick the top of it. If it holds and doesn't start bleeding, the surgery is a success. He seems to know quite clearly that if it doesn't hold, he's screwed, but Meredith tries not to focus on the "possible death" outcome. They then ask her success rate, and she has to unfortunately answer that this is her first procedure. The guy's wife loses her smile, though kudos to her for struggling very hard to not be obvious about it, and the guy admits he wishes she'd just lied. Derek has been standing in the doorway but he finally walks in and says that after today, she'll have a 100% success rate, and that she is the best. He also assures them that he will be there the whole time. For a brief moment, he's actually acting like a gracious human being and I can see just a teensy bit of that good-looking McDreamy of yesteryear.