The truth. It stings sometimes. We all know this to be true, and all of our favorite doctors are about to find this out in one way or another. Cue the elevator. Lexie is giving Alex eyes as a group of interns enter and gush about how an intern totally saved a guy yesterday and how he never makes a mistake during rounds. Heâ€™s the best intern ever! It's George! Lexie convinces Alex not to blow his cover.
On a different elevator, Meredith and Derek chat awkwardly. Cristina picks up on the fact that Meredith is doing McDreamy and dodging her because of the Burke situation. She decides to use this to her advantage and finagle - what else - surgeries out of Mer's sympathy.
Thereâ€™s a new doctor in Seattle, and while he's got to be old enough to be our interns' grandfather, Norman is Alex's intern. This leads to some funny exchanges. They meet a patient whose mom thinks her son is on drugs because heâ€™s lethargic, cranky and his grades have been slipping. Norman, having worked in a pharmacy for 30 years, assumes she's right.
However, the teenagerâ€™s toxicology results come back negative. Norman is shocked. That's when the kid - who insists he's clean - gets annoyed and tells is mom that she has apple hair and he threw the pancake into the river. Alex asks what he was trying to say just then and he says he wanted to go home. Alex orders a CT scan.
The chief treats a woman who has tongue cancer. Sheâ€™s very talkative. Mark has to remove 60 percent of her tongue and replace it with grafts, which may make it hard for her to talk again. The Chief wants to try a procedure that would allow her to have full use of her tongue. The only problem? It has never been done before.
The lady is freaking out about the prospect of not being able to talk. She says she has so much to say. George tells her to just say it if she's got something on her mind. The woman does, and she ends up hurting her friends' feelings with some personal criticisms. Sometimes the truth stings.
The tongue surgery hits a snag and The Chief and Sloan admit they got in over their heads. They page Derek because heâ€™s good with nerves. Derek comes in and takes over, and eventually saves the day. Unfortunately, thatâ€™s when teenager Alex is treating decides to collapse.
His pupil is blown and spinal fluid is backing up and putting pressure on his brain. Derek, while assisting Mark and the Chief, tells Alex what he must do in the next 10 minutes or the kid will die - get a tongue depressor and stick it under the kidâ€™s eyelid, the take a gigantic needle and drain the spinal fluid from behind the eye. On his own, saves the day!
Since Meredith gave Cristina a cool surgery to make her "feel better," she is stuck with Lexie as her intern. A trauma comes in where there has been a car accident and a patient has been down for 24 minutes. Meredith lets Lexie do her first intubation and the guy cannot be revived. Lexie freaks and calls Meredith a bad doctor, essentially. Sick of her hysterics, Mer banishes Lex to the clinic.
Bailey then takes over and tells Lexie that the clinic isnâ€™t a place for stray interns, and to go give a kid stitches. Later, Meredith gives Lexie her motherâ€™s death note to share with her. She wants to go over it so Lex can have closure, and understand that it wasn't Meredith's fault, that it was a 1:100 chance what happened to Lexie's mom. They share a nice moment as Mer tells Lexie that she was very fond of her mother.
Callie has been hiding out doing paperwork because she can't handle the job. Bailey has been running the show. But Miranda has a heart to heart with her and tells her that she has been having trouble not being #1, so she's going to get over it and be her #2 - the best #2 ever. Together, Bailey says, they can do this and do it well. Callie smiles.
Meanwhile, Izzie is stunned when Really Old Guy wakes up and announces his name is Charlie Yost ... and that he only woke up so he could die. That's hard, though. He starts tearing cords out of the wall and unhooking the mechanisms that are keeping him alive. He stops breathing, but Izzie is able to revive him... much to his chagrin.
In between trying to end the suffering, he gives Izzie some advice. Charlie says if somebody really wants to do something, then they do it â€” heâ€™ll die if he wants to, in other words, while George isnâ€™t leaving Callie (he knew about the love triangle while semi-conscious in his coma, of course).
After talking with ROG, Izzie finds George and confronts him. He says it's not about him and her, that itâ€™s about him and Callie. Heâ€™s about to break up a marriage to a great woman and she needs to get off his back and let him do it. Itâ€™s not exactly something you just blurt out.
Later, Really Old Guy is checking out of Seattle Grace. He's all dressed up and ready to go in his wheelchair. That's when he dies peacefully. Izzie brings everybody in so they can have a mini-memorial for him. After the surgeons each say some nice words, Izzie talks about how Charlie was a bastard, but a bastard who knew what he wanted, didnâ€™t stop until he got it. Hint, hint, George.
After a moment in which Alex inexplicably blows George's repeater status in the elevator, George returns to the hotel and finds Callie on the bed with her bags packed. She tells him to just say it. Her face says she already knows the truth and that it most certainly stings. As the screen fades to black, George looks at her and says,
â€œI slept with Izzie.â€