Time to check in with Plucky Jake. Mark's drawing all over his face with a marker as Cristina watches. The parents enter along with Derek and tell Jake that they're sorry, but the brain surgery is very dangerous and they think he should forget about the cosmetic surgery. Mark pipes up that, as long as Jake is already under for the brain surgery, they might as well do the facial surgery, because putting him under for additional surgery would be excessive. Oh, sure. Because dipping your fingers into someone's brain for several hours and then ripping their face off and sawing through their bones DIRECTLY AFTERWARD isn't excessive at all. Oh ho, no. Jake says that he's almost died a couple of times and that he may die this time too, but that doesn't mean he doesn't want a new face. He begs them to let him be normal for once in his life.
After this touching scene, McDreamy needs a distraction, so he hunts down Meredith in a corner office somewhere so he can confuse her and mess with her mind a little. It's his favorite pastime. Mere's stuffing BDG's videos into envelopes and getting them ready to mail. She says she's fulfilling a dying man's wish to send hate mail to everyone he's ever met. Derek says he understands the impulse. Mere does too. "Why do people cheat?" she asks. "That's a good question," he says. Mere asks why he thinks Addison cheated on him and he says that he was absent from the marriage. Not that that's an excuse or anything. Mere asks if he thinks she would have cheated if they'd had kids and Derek doesn't know. McDreamy looks at her McDreamily, and Mark chooses this precise moment to enter and tell Derek that Jake's ready for surgery. "Oh, I'm sorry," he says with more than a note of snarkiness to his voice. "Am I interrupting something?" Mere and Derek rush to opposite ends of the planet in order to show him that no, he isn't.
The Orgasmatron. SOG is clenching and tensing and Izzie tells her she should relax. Unfortunately, she IS relaxing. Apparently, the orgasms happen when she doesn't relax. She asks if Izzie thinks the doctors can fix this problem. Izzie rather dumbly asks if it would be the worst thing if the doctors couldn't fix it. SOG is like, look, dude, I love sex as much as the next person, but I'm not really fond of having an orgasm while I'm standing in line at the deli counter or while I'm at my accountant's or, god forbid, while I'm at CHURCH with my PARENTS. Izzie finally gets it and shows sympathy toward her, and then we switch over to Burke and Mere as they're operating on BDG. Meredith tells Burke about the vitriolic videotapes and how this guy spewed every bad feeling he ever had onto them. Burke asks if she mailed them, and she said she didn't because he was in shock and scared and not himself. Burke tells her that that's not up to her, that the guy asked her to do something for him and she should do it. "If you don't," he says, "it doesn't make you noble. It makes you a liar." Then Burke asks if Mere knew Cristina kept her apartment, and Mere reluctantly says that she did know and that she's sorry. Hovering over the table, BDG's transient soul looks down and shouts, "Hey! How about concentrating on the LUNG on the TABLE in FRONT of you and leave the chit-chat for the dinner table, HUH?"