Okay, cooled off. Meredith tells him to shut up, and he laughs. She mentions the baby. "He's brand-new. No one's neglected him or damaged him yet. How do we get from there to here? She's wearing my shoes and someone's beat the crap out of her. And she's got nobody." At hearing this, the core of Meredith's bad day, he's sufficiently brought down. Allison's monitors starts beeping, and when McDreamy rushes in to assess her, he immediately orders an OR for a craniotomy.
Post-surgery, he's agitated. "I had to leave her skull flap off until the pressure in her brain goes down." Meredith thinks she's not going to make it, but Derek says she'll be fine. "If she ever wakes up," she adds. He has to concede the point. "If she ever wakes up." Leaving a poor girl's skull flap open really does water down the sexual tension.
The next morning, still at the hospital, Derek asks Burke to go get the drink Burke had asked about earlier. Burke puts him off, but after he persists, Burke tells him, "Shepherd, you should know that Richard promised Chief to both of us." When McDreamy nods, Burke realizes he knew all along. McDreamy just smiles and tells him, "Keep your friends close and your enemies closer." This seems to make Burke feel better about the whole thing, and he corrects, "You're not the enemy. You're just the competition."
In the Chief's office, Meredith finally gets to relinquish custody of the wayward appendage. As they sign the papers, the Chief realizes that he can't utter the word "penis" around her since he once changed her diapers. I'd mock, but it's true.