Dwight makes a call to Jan, who is frankly disgusted that he's bothering her, and who most definitely will not give him the requested permission to fire Jim. During this call, it comes to light that Dwight is in charge of the health-care plan, which Jan is not excited about, and she winds up ordering Dwight to never call her on her cell phone again. Michael is in, as they say, troub-blllllle.
Michael returns to the office with ice-cream sandwiches, filled with hope and satisfaction that, although he didn't wind up solving the problem as well as he'd hoped, he's at least solved the problem. As he throws them around the room, he drips with relief that he has solved the problem of the surprise, until Stanley tells him that this had better not be the surprise, because the day has been much too rotten for ice-cream sandwiches to make up for it -- at which point Michael instinctively agrees, assuring Stanley that no way no-how is this the surprise. Of course not! Michael ignores Dwight's ongoing begging to be let out of the conference room, and then when Michael is gone, Jim puts aside witty teasing and clever manipulation for a moment and just flat-out hurls an ice-cream sandwich so that it bounces off the window in front of Dwight's face. Sometimes, the cheapest joke is the most precious. A concept to live by, people.
Poor Dwight is at his wit's end, so he gathers everyone for a meeting in which he says that he will read off the submitted medical conditions, and someone will have to take responsibility for each, or it won't be covered. He assures them that they've all forfeited their right to confidentiality, presumably by writing down things like "--east ears." He announces that he's apparently the only adult in the room, and we're off: "Number one: inverted penis." There is quiet. Finally, Meredith tentatively raises her hand: "Could you mean 'vagina'? Because...if you do, I want that covered." Dwight says he thought she didn't have a vagina anymore after her hysterectomy. "A uterus is different from a vagina," she says with a combination of embarrassment, horror, disgust, and condescension. "I still have a vagina." Her delivery on that line makes this scene for me.