Back with Mr. Pretzel, the doctors are all surveying the damage. They need to get his femur removed from his shoulder before they can really tell what is going on. Callie doesn't think she can save his leg though. Since it is imbedded in his shoulder and all. They move to untwist Mr. Pretzel. They each take a limb and start pulling. Just as Callie is directing the maneuver, Mr. Pretzel wakes up. He scares the bejeezus out of the doctors. They pump him full of morphine and go out for a cigarette and a shot. Oh please, you would too! They were scared! And he is gross. Sorry, Mr. Pretzel! Mr. Pretzel screams in agony and tells all the doctors to get their hands off of him. Hunt believes in Patients First! (It's on his family crest) and orders all the doctors to stop. Shepherd looks annoyed, but how can you argue when you are doing what the patient wants? Hunt explains the haps to Mr. Pretzel and Mr. Pretzel replies that whatever they do to him he has to be able to walk.
Bailey is giving Dixon a guided tour of the hospital, but all of Bailey's fake-nice small talk is cut short by Dr. Dixon's recitation of fun factoids and mutterings of "Surrender Earthlings!" Bailey practically begs Alex to interrupt the tour to give a patient update. The patient was supposed to receive a transplant six years ago, but the heart was too small so the doctors doubled up and did a "piggyback." At the mention of the word "piggyback" Dr. Dixon gets panicky and sharp. She tells Alex not to use the colloquial name for the procedure. She rocks back and forth and stares at the ground. The patient is a Wizened Navajo. Why would a Navajo be in Seattle? I'm not saying it doesn't happen, but in Seattle it is so much more likely to be from the Yakima or Makah or Muckleshoot tribe than Navajo. But I guess Navajo is television writer short hand for Native American with Deeply Held Spiritual Beliefs and Great Understanding of the Natural Order of Things. I blame Tony Hillerman. May he rest in peace. The Wizened Navajo is recounting to Izzie (and Denny) the many ways that he has lost touch with his people and the Old Ways by taking the donor heart. His people don't even touch the dead! He is being haunted by the heart and he wants it out. And, no, he doesn't want a new donor heart, he wants nothing to do with this newfangled medicine. He wants to go back to the Old Ways of his people. At that, Ghost Denny starts yelling at the Wizened Navajo that he should TAKE THE DAMN HEART! Because some people aren't so lucky as to be able to refuse a perfectly good heart when it comes along. Izzie ignores him. Dr. Dixon comes to meet the patient just as he is announcing that he doesn't want the heart. Dixon tells him he will live a short bad life hooked up to machines if he refuses the heart and Denny shouts "Hell, yeah!" in agreement. The Wizened Navajo still says no. Old ways or no ways.