Sarabeth heads into Michael's room, looking pained. Alex explains that they're taking him to the OR soon, and the look on Michael's face indicates that he knows that she knows. Lexie pipes up that Michael wrote Sarabeth a letter, but she doesn't want to hear it and turns to leave, so Lexie just begins reading. She's too cutesy and awkward and interjecting her own stupid comments, and all in all it's painful to watch. Instead I'll focus on Bernadette Peters' acting here (and in this whole episode) which is awesome -- you can see her struggle between wanting to believe what he is saying and wanting to forget him forever because her heart is crushed. Michael's letter confirms everything Alex theorized, that he was too scared to tell his wife so he told her friend instead. He then tells her that he's going to do everything he can to make it up to her and that no matter what, he loves her forever. Michael, George, and Sarabeth all look pained and sad while Lexie acts like a ditz, and after a long look at her husband, Sarabeth just turns and leaves.
What must be a little while later, Izzie comes to the waiting room to tell the women that they can see Betty even though she's not yet awake. Izzie admits they don't know yet if her memory is okay or not. Anna looks sadly at Sarabeth, who does her best to not look back. But then Meredith arrives to let them know about Vincent, and though Anna begs her not to say it, Meredith confirms that he died. Both women crumble, but Sarabeth turns and tries to walk away when Anna tries to hold her hand. Anna follows her, though, and turns to face her. She recounts Vincent's death, Betty's surgery, and mentions Philip and Michael, but Sarabeth growls at her never to speak his name. Anna begs her, saying that more bad things have happened to them today than ever before, but that they've been blessed before today, and that she took her for granted. Izzie and Mere watch, sad and embarrassed, as Anna reminds Sarabeth that they've been friends for fifty years, and tells her she needs her best friend. Sarabeth finally loses her cool and cries, "You slept with my husband!" She says she's going to see Betty, her friend. After she leaves, Mere says, "Sorry about teasing Alex." Izzie answers dully, "I forgive you," and walks away. The caliber of the acting in that scene with Bernadette and Kathy put much of the rest of this episode to shame.