Richard (James Pickens Jr.) pages Meredith about a wedding present. He says that it's Derek's present to her, but it doesn't really make sense, so I'm going to fanwank that it's actually Richard's present. Meredith doesn't want any gifts because she thinks all of the gift-giving stuff that comes along with weddings is silly, but then Richard says that the present is actually an inflamed colon, and assigns her to her first solo surgery. Aww, that's really sweet, and just what Meredith would have wanted. The reason why it doesn't make sense for it to be Derek's gift is that Derek, being a neurosurgeon, wouldn't really have anything to do with this kind of surgery.
George's first trauma patient dies, and he has a hard time letting, but Hunt convinces him that you can't save everything, and you have to move on to save the ones you can.
Arizona (Jessica Capshaw) interrupts Callie's hectic day in the pit, passive-aggressively asking her what's up? They had gone to a great four-star restaurant, and it was supposed to be special and romantic, but all Callie did was order a salad and then bail afterwards. Callie doesn't really respond to this because she has so much going on in the ER. She runs off to yell at some paramedics instead of talking to Arizona.
Bailey tries to convince Izzie to stay positive as she gets her ready for the MRI, but Izzie is convinced that it's a tumor. Denny is standing right behind Bailey and says hi to her.
Becca, Alex's talkative patient, continues the grand tradition of Grey's Anatomy
patients metaphorically spilling their guts. She tells him about how she should have slept with David, George's patient who just died, when she had the chance, but now he's dead and he can't.
Cristina's patient also starts talking very personally about his significant other. He explains that his folks are too po' for him to stay in Seattle, or something, I kind of missed it. Anyway, the point is that he has to be separated from his girlfriend. They knew that their relationship wouldn't last, and he says something like, you can't always be with the person you love, which is allegorical to Cristina and Hunt's relationship.
George is working on another patient who is bleeding so much that there's no way to save him. After he dies, George is so disgruntled that he lost another patient that he asks Hunt to pull him from the pit. He's in over his head. Hunt will not pull him, so George has to go back to work. Another patient is brought in, and she's practically cut in half, and her guts literally are spilling out. She's so D.O.A. She turns out to be the girlfriend of Cristina's patient, who is walking by and sees her. When he realizes that his girlfriend is dead, he collapses and starts coding.
Richard scrubs in on Meredith's colon surgery, which annoys her a bit since it's supposed to be a solo surgery. He gets very parental on her, commending her on the way she asked for the scalpel, and "hmmmmm"ing every time she makes a move. He's getting on her last nerve. Mark (Eric Dane) crashes the party as well to tell Meredith that she better not leave Derek because he doesn't want to be Derek's best man a third time. She's all, "Are you threatening me?"
Arizona tries to call Callie on her evasiveness. She wonders why Callie was so tired after their date, yet she has all this energy to be working the ER. Callie says that she rallied because she loves the pit. Arizona knows that she is lying and wants to know what's up. Arizona gets angry and wants to know if their relationship was just a fling. Maybe it's over now. Callie says, "Maybe it is."
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