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Derek has a shouting match with Meredith over whether he should tell the hospital board that the Chief fell off the wagon. He didn't go to the board right away because Meredith pulled out her trump card: Post-It style.
So Derek tries to find a new way to deal with the Chief - first complaining about the lack of sterile supplies, then offering his help, which the Chief rebuffs.
Then, Derek points out that he's not operating and only teaching Meredith, the Chief decides it's time to get back into surgery. He plans for Avery and Meredith to join him - and for Meredith to perform a very intense procedure.
Bailey is really angry, and unloads to Derek. That morning she performed an incredibly interesting and difficult procedure involving "hot" chemotherapy in the body cavity, and the Chief wasn't there to see it.
Now he's got Meredith scrubbing in on a seven-hour surgery? The Chief's judgment is not clear and rational, she tells Derek, who eventually mans up for Bailey after talking to Owen about weighing the risks of engaging in battle.
What Derek does is bring a bottle of scotch to the Chief, pour him a glass, and imply that he'll drink it, even if he doesn't want to. Wow.
Bailey takes over the Chief's surgery because he's in his office sleeping it off, and Derek tells Meredith he'll hire back Izzie (more on that later) if the board makes him Chief, he tells her.
Eventually she relents, although she's left wondering if it was the right decision.
The question of the night for Teddy and Cristina and Owen is career vs. love to begin with. Much as she wants to take back her previous comments, the more Cristina thinks about it, the more indignant and unabashed she gets about prioritizing her career.
Meredith warns her to keep this internal debate to herself.
But after listening to her opera singer patient with lung cancer explain how badly he needs his work, she tells Teddy that between fulfilling her gift and a guy, she chooses her gift.
Drunk Teddy spills the beans to Owen at Joe's, telling him that Cristina offered to give him up. In the end, poor Owen confronts Cristina and tells her that while surgery matters, people matter, and their relationship matters. Cristina's eyes well up as she surrenders to their relationship.
Izzie's back, and she seems to think she and Alex will be OK. She's applying for jobs and wants one in Tacoma because it's close by. An hour earlier, Meredith discovered him in the sack with Lexie they agreed to keep their mouths shut.
Eventually, Alex confesses that he slept with someone else, and Izzie seems genuinely intent on making things right between them.
She also seems to have gained a little perspective, finally understanding that for her love is more important than career.
Alex is working with Cristina and Teddy on the opera singer, and from talking to the guy's suffering partner he realizes how torturous it is to be involved with someone who doesn't respect them.
When he finds out that Izzie's scans are clear, he tells her how happy he is for her, but that even though he's no saint he deserves to be with someone who will stay.
So she decides to leave again, even after Meredith giving Derek the OK to go to the hospital board means she has a job again.
Despite Meredith asking her to stay, Izzie's moving on.
Finally, Callie gets chicken pox. Arizona puts her in quarrantine and says since she hasn't had the pox or the vaccine, she can't take care of her, and puts Lexie in charge.
Then Mark shows up, back from L.A., confessing to Callie that he slept with Addison and helping scratch her itch. Literally. Arizona confesses that she really just didn't want to deal with Callie with pox because it's not sexy.
Mark blurts out his Addison liaison to Lexie, who's relieved and tells him about Alex. But Mark gets all hurt, leaving Lexie staring after him.