Meredith, at Derek's prompting, tries to ask Lexie if she's doing okay, or whether she's a secret cutter. At that, Lexie tells her interns that they have to halt their operations for a while until the suspicions die down, but Sadie, who is a new recruit into the secret intern society, nixes the idea. She wants to take more risks, not fewer. She takes off her scrub top and cuts her back with a scalpel. See how she's a rebel?
Mer gleans from Cristina that Mark might have his eye on Lexie, so she asks Derek to ask Mark to keep his Little Sloan out of Little Grey (Lexie). She doesn't want Mark to go all man-whore on her little sister. He agrees to because he's touched that Mer actually cares about her little sis. His conversation with Mark is very funny – Mark says it's not Little Sloan, actually. It's Big Sloan.
Izzie asks her patient about how to get rid of ghosts. There's a nine-day ritual involved get rid of the ghosts, in wich you have to burn all the belongings of the deceased that are made of fabric. Metal can be cleansed, but not fabric. What this means to Izzie is that she's gotta get rid of the sweater she made for Denny. Also, this means that the patient wants her off the surgery because he doesn't want her ghost running around while his chest is opened up. During surgery, Izzie watches from the viewing gallery. Denny's there also, insisting that he's real. He says that he can touch her and that will prove that he's real. You know, I've always liked Jeffrey Dean Morgan, but I never noticed until now how damn attractive the man is. I don't mind this Izzie-is-going-crazy storyline as long as we get to see Jeffrey Dean Morgan every week. (Incidentally, I don't actually think she is going crazy. She probably has a brain tumor that is making her see things, or something.)
Down in the OR, the heart that they just detached starts beating on its own. Very strange. This puts Dixon in a tizzy because it doesn't make any sense. But anyway, it's good news because that means that the man won't have to have an LVAD or any other machines. Good thing, because you know how Izzie gets when she sees an LVAD wire.
Derek finally convinces Timothy to get surgery. Little Grey assists, and the attention Mark pays to Little Grey for correctly executing a difficult suture doesn't go unnoticed by Meredith or Derek. Richard pops his head in to see how the surgery is going. When he learns how well Lexie is doing, he compliments Cristina for being such a good teacher. He hints that she may be getting to do the first solo surgery.
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