Derek and Meredith are comparing titanium deposits that they found all over the hospital with their spelunking gear and 49er maps. Their conversation is interrupted when Lexie walks by and Derek shoves Meredith after her to find out about Lexie's secret inner pain that is causing her to self mutilate. Meredith asks Lexie if she's okay and Lexie doesn't know how to respond. Is this Meredith her boss? Or Meredith her sister? Meredith tells her she is pretending to care that her sister is a secret cutter. Lexie denies it, but her denial is cut short when Sloan asks her to get involved with Callie's surgery. He calls her Little Grey and Meredith is bothered. Not just because Sloan called her Big Grey, but because he seems to be flirting with Little Grey. Secret cutting is one thing, but getting cozy with manwhore Sloan? Not her little sister! Lexie runs off before Meredith can talk to her.
Hunt goes to talk to Mr. Pretzel. He knows that he is a fighter and has been through a lot. Mr. Pretzel doesn't want to hear it from Hunt. He doesn't want to see pity in his eyes. He made a choice! He took a turn, he couldn't connect, he made a choice. He made a choice and took a turn. He does not regret it. His choice. A choice to speak like a high school poet's journal entry. Shepherd eavesdrops approvingly at Hunt's attempts to get Mr. Pretzel to agree to surgery.
Lexie has returned to the Secret Intern Cutting Society. She wants them to lay low for a while because people are starting to catch on. Maybe if the interns left that room every once in a while people wouldn't be so suspicious. Sadie is lurking in wait. When Lexie tells everyone to be less risky, Sadie calls them out. They should take more risks! Use less anesthetic! They should cut bigger! Deeper! Longer! Five by five, man! She rips off her shirt, grabs a scalpel, and slices open her shoulder. When she asks who wants to stitch her up, everyone raises their hands. Sing with me now: They're creepy and they're kooky, mysterious and spooky, they're altogether ooky, the intern cutting society!
Meredith realizes that Sloan really might be angling for Lexie. Since she doesn't want Sloan to get his Little Sloan anywhere near her little sister. She asks Derek to talk to Sloan about staying away. Derek agrees to because he is so happy that Meredith actually has enough human emotion in her solipsistic skeletal frame to care about her little sister. So in exchange for talking to Lexie about the cutting, Derek will talk to Sloan.